Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | 58342-2 | SD |
NPI | 1013142306 |
---|---|
Provider Name | Julie Ann Thompson |
First Address | Rapid City, SD 57701-7351 |
Second Address | Rapid City, SD 57701-7351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2009 |
Last Update Date | 22/06/2010 |