Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 000241971 | TN |
NPI | 1255095915 |
---|---|
Provider Name | Angela Bond |
First Address | Jackson, TN 38305-2824 |
Second Address | Jackson, TN 38301-6200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2021 |
Last Update Date | 28/10/2021 |