Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1184177891 |
---|---|
Provider Name | Jamie Christiansen |
First Address | St George, UT 84790-5457 |
Second Address | St George, UT 84790-5457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2016 |
Last Update Date | 28/07/2016 |