Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1073884730 |
---|---|
Provider Name | Christine Javier |
First Address | Marietta, GA 30062-7204 |
Second Address | Marietta, GA 30062-7204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2012 |
Last Update Date | 21/02/2012 |