Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 11414 | TX |
N | 101YS0200X | School Counselor | TX |
NPI | 1205912680 |
---|---|
Provider Name | Elizabeth Faye Wedell |
First Address | Bonham, TX 75418-0812 |
Second Address | Bonham, TX 75418-4365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2006 |
Last Update Date | 08/07/2007 |