Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1194094458 |
---|---|
Provider Name | Demetrice Adams |
First Address | Covington, TN 38019-3630 |
Second Address | Covington, TN 38019-3630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2011 |
Last Update Date | 15/12/2011 |