Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1023416203 |
---|---|
Provider Name | Artavia Womack Wison |
First Address | Las Vegas, NV 89129 |
Second Address | Las Vegas, NV 89129-6909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2014 |
Last Update Date | 19/12/2014 |