Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 1587059 | IN |
NPI | 1235769506 |
---|---|
Provider Name | Leah Bunger |
First Address | Bloomington, IN 47401-6754 |
Second Address | Bloomington, IN 47404-3385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2020 |
Last Update Date | 24/01/2020 |