Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | A12863 | NC |
NPI | 1003329509 |
---|---|
Provider Name | Angela Kaye Moralee |
First Address | Cookeville, TN 38501-9451 |
Second Address | Cookeville, TN 38501-5066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 22/07/2020 |