Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701003602 | VA |
NPI | 1003081464 |
---|---|
Provider Name | Katherine Ann Flaherty |
First Address | Blacksburg, VA 24060-2706 |
Second Address | Blacksburg, VA 24060-2706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 28/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4945191 | (05) | VA |