Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC010345 | PA |
N | 101YS0200X | School Counselor | 5087242 | PA |
NPI | 1114420981 |
---|---|
Provider Name | Karen B. Walters |
First Address | Monroeville, PA 15146-1515 |
Second Address | New Kensington, PA 15068-6441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2018 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PC010345 | STATE LICENSE (01) | PA |