Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | CC5237 | ME |
NPI | 1003140740 |
---|---|
Provider Name | Julie Kristen Randall York |
First Address | Pittsfield, ME 04967-4747 |
Second Address | Skowhegan, ME 04976-4823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2009 |
Last Update Date | 02/08/2019 |