Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003253113 |
---|---|
Provider Name | Janet C Bunch |
First Address | Rock Hill, SC 29732-1186 |
Second Address | Rock Hill, SC 29732-1186 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2013 |
Last Update Date | 30/05/2013 |