Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | MH5779 | FL |
N | 101YP2500X | Professional Counselor | 20247 | TX |
NPI | 1003820713 |
---|---|
Provider Name | Elizabeth Rita Pixley |
First Address | Niceville, FL 32578-4246 |
Second Address | Crestview, FL 32539-3547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |