Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 711488 | FL |
NPI | 1073908489 |
---|---|
Provider Name | Micah Harrell |
First Address | South Miami, FL 33143-3320 |
Second Address | Orlando, FL 32805-3118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 02/04/2015 |