Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | A10868 | NC |
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1225430457 |
---|---|
Provider Name | Esther Mendez |
First Address | Kernersville, NC 27284-3290 |
Second Address | Winston Salem, NC 27107-1361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2014 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8260409 | NCDL (01) | NC |