Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0016129 | CO |
NPI | 1003425083 |
---|---|
Provider Name | Kelsie Leigh Mcguire |
First Address | Pilot Point, TX 76258-6932 |
Second Address | San Antonio, TX 78213-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2020 |
Last Update Date | 27/07/2020 |