Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 6401015066 | MI |
NPI | 1003285073 |
---|---|
Provider Name | Karyn Elizabeth Aguilera |
First Address | Saginaw, MI 48604-2329 |
Second Address | Saginaw, MI 48604-2329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2015 |
Last Update Date | 21/09/2015 |