Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 69074 | TX |
NPI | 1003244203 |
---|---|
Provider Name | Aaron Clark Turner |
First Address | Longview, TX 75604-1231 |
Second Address | Longview, TX 75604-1231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2013 |
Last Update Date | 24/10/2013 |