Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003332198 |
---|---|
Provider Name | Chelsea Garin |
First Address | Bunkie, LA 71322-1561 |
Second Address | Bunkie, LA 71322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2017 |
Last Update Date | 21/08/2017 |