Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 0072384 | MO |
NPI | 1013166610 |
---|---|
Provider Name | Angie Fitzpatrick |
First Address | Strafford, MO 65757-7844 |
Second Address | Springfield, MO 65807-1287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 18/09/2008 |