Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | AZ |
NPI | 1003583329 |
---|---|
Provider Name | Christine Lynn Metheny |
First Address | Avondale, AZ 85392-4863 |
Second Address | Phoenix, AZ 85016-7699 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2021 |
Last Update Date | 25/08/2021 |