Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | A13712 | NC |
N | 225C00000X | Rehabilitation Counselor | 00211221 | NC |
NPI | 1053955187 |
---|---|
Provider Name | Kelsie Ann Adkisson |
First Address | Durham, NC 27712-1464 |
Second Address | Raleigh, NC 27612-3266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2019 |
Last Update Date | 09/03/2020 |