Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC-20359 | AZ |
NPI | 1003571399 |
---|---|
Provider Name | Julie Seifert |
First Address | Phoenix, AZ 85012-2020 |
Second Address | Phoenix, AZ 85022-5306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2021 |
Last Update Date | 02/11/2021 |