Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 4233 | LA |
NPI | 1003285180 |
---|---|
Provider Name | Leemarie M Spatafora |
First Address | Clinton, LA 70722-0395 |
Second Address | Clinton, LA 70722-3210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2015 |
Last Update Date | 07/03/2018 |