Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301006941 | MI |
N | 103TH0100X | Health Service | 6301006941 | MI |
NPI | 1023081296 |
---|---|
Provider Name | Dr. Sarita R Overton |
First Address | East Lansing, MI 48823-8465 |
Second Address | East Lansing, MI 48823-8465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 06/10/2011 |