Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1235520933 |
---|---|
Provider Name | Ellen Beth Roork |
First Address | Beaumont, TX 77710-0034 |
Second Address | Beaumont, TX 77706-3611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2015 |
Last Update Date | 10/08/2019 |