Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 6690 | NC |
N | 101YS0200X | School Counselor | 1587 | NC |
NPI | 1184067662 |
---|---|
Provider Name | Ella Julia Powell Forehand |
First Address | Windsor, NC 27983-2027 |
Second Address | Wilmington, NC 28401-7903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2013 |
Last Update Date | 15/04/2013 |