Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 15007 | NC |
N | 101YM0800X | Mental Health Counselor | 37AC00212800 | NJ |
NPI | 1003213117 |
---|---|
Provider Name | Greta Enriquez |
First Address | Emerald Isle, NC 28594-2716 |
Second Address | Emerald Isle, NC 28594-2716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2014 |
Last Update Date | 30/07/2019 |