Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YS0200X | School Counselor |
NPI | 1154087716 |
---|---|
Provider Name | Janette Dantzler |
First Address | Orangeburg, SC 29118-2042 |
Second Address | Orangeburg, SC 29118-2042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2021 |
Last Update Date | 09/11/2021 |