Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH6698 | FL |
N | 101YS0200X | School Counselor | ||
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1164638607 |
---|---|
Provider Name | Ginger Hannigan |
First Address | Treasure Is, FL 33706-4747 |
Second Address | Saint Petersburg, FL 33707-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0197221100 | (05) | FL |