Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | LPC-0356 | AZ |
NPI | 1003122136 |
---|---|
Provider Name | Beverly Seyler |
First Address | Gold Canyon, AZ 85118-7012 |
Second Address | Phoenix, AZ 85042-5359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/08/2010 |