Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003240458 |
---|---|
Provider Name | Anne Elizabeth Zuber |
First Address | Lawrenceville, IL 62439-0516 |
Second Address | Lawrenceville, IL 62439-9301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 21/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
207184 | (02) | IL |
376006178008 | (05) | IL |