Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | A10074 | NC |
N | 101YS0200X | School Counselor | NC |
NPI | 1114339983 |
---|---|
Provider Name | Aja Thomas |
First Address | Greensboro, NC 27407-2377 |
Second Address | Greensboro, NC 27407-2377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2014 |
Last Update Date | 28/05/2014 |