Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | AZ |
NPI | 1245411206 |
---|---|
Provider Name | Heidi Klinefelter |
First Address | Sierra Vista, AZ 85635-2392 |
Second Address | Sierra Vista, AZ 85635-2392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2007 |
Last Update Date | 19/11/2007 |