Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003407347 |
---|---|
Provider Name | Brittney Cornette |
First Address | Maiden, NC 28650-9127 |
Second Address | Gastonia, NC 28052-4035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2021 |
Last Update Date | 29/01/2021 |