Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC- 12616 | AZ |
NPI | 1003060872 |
---|---|
Provider Name | Debra L. Minetor |
First Address | Tucson, AZ 85721-0001 |
Second Address | Tucson, AZ 85721-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2008 |
Last Update Date | 06/11/2008 |