Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 15938 | AZ |
NPI | 1033699210 |
---|---|
Provider Name | Anna Rachel Seno |
First Address | Prescott, AZ 86303-4253 |
Second Address | Prescott, AZ 86303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2018 |
Last Update Date | 17/08/2018 |