Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1073816203 |
---|---|
Provider Name | Jazmin Pazmino |
First Address | Champaign, IL 61820-7143 |
Second Address | Champaign, IL 61820-7143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2010 |
Last Update Date | 09/12/2010 |