Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2358 | AL |
NPI | 1003201302 |
---|---|
Provider Name | Annie Adams |
First Address | Montgomery, AL 36109-1832 |
Second Address | Montgomery, AL 36109-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 02/04/2015 |