Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 68267 | TX |
NPI | 1003199142 |
---|---|
Provider Name | Carolina I Campos |
First Address | Edinburg, TX 78539-6672 |
Second Address | Edinburg, TX 78539-6672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2011 |
Last Update Date | 29/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
68267 | TX STATE BOARD OF EXAMINERS PROFESSIONAL COUNSELORS (01) | TX |