Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 24166 | NC |
N | 101YM0800X | Mental Health Counselor | A13735 | NC |
Y | 101YP2500X | Professional Counselor | A13735 | NC |
NPI | 1003063454 |
---|---|
Provider Name | Jill Siske |
First Address | Sylva, NC 28779-2187 |
Second Address | Waynesville, NC 28786-6703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2008 |
Last Update Date | 08/02/2018 |