Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | A14244 | NC |
Y | 101YS0200X | School Counselor | 1193077 | NC |
NPI | 1023641271 |
---|---|
Provider Name | Lydia A Kiefer |
First Address | Durham, NC 27701-2972 |
Second Address | Durham, NC 27703-2606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2020 |
Last Update Date | 17/02/2020 |