Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 171134 | MS |
NPI | 1053959874 |
---|---|
Provider Name | Leotyne Anderson |
First Address | Saltillo, MS 38866-8109 |
Second Address | Saltillo, MS 38866-8109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2019 |
Last Update Date | 11/12/2019 |