Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701006649 | VA |
NPI | 1003269366 |
---|---|
Provider Name | Anissa Howerton |
First Address | Danville, VA 24540-3124 |
Second Address | Danville, VA 24541-2823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2016 |
Last Update Date | 21/07/2016 |