Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | MO |
NPI | 1144750936 |
---|---|
Provider Name | Julia Dooley |
First Address | Saint Peters, MO 63376-4514 |
Second Address | Hazelwood, MO 63042-1740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 14/06/2017 |