Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 5313 | NC |
Y | 103T00000X | Psychologist | 5313 | NC |
N | 103TC1900X | Counseling Psychologist | ||
N | 103TH0100X | Health Service | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1093371395 |
---|---|
Provider Name | Dr. Sara Klco |
First Address | Banner Elk, NC 28604-7057 |
Second Address | Asheville, NC 28805-2576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2019 |
Last Update Date | 13/05/2019 |