Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1013311026 |
---|---|
Provider Name | Anne Kiley |
First Address | Leesburg, VA 20176-2236 |
Second Address | Leesburg, VA 20176-2236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2014 |
Last Update Date | 20/10/2014 |