Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 60046 | TX |
Y | 101YS0200X | School Counselor | TX |
NPI | 1225322340 |
---|---|
Provider Name | Courtney Marie Cardosa |
First Address | Austin, TX 78727-2817 |
Second Address | Austin, TX 78727-2817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2011 |
Last Update Date | 06/06/2011 |