Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | A13795 | NC |
N | 101YP2500X | Professional Counselor | A13795 | NC |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1003124710 |
---|---|
Provider Name | Jillian Vandegrift |
First Address | Asheville, NC 28806-1714 |
Second Address | Asheville, NC 28801-2206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 01/11/2019 |