Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2008013577 | MO |
NPI | 1003075482 |
---|---|
Provider Name | Miss Charlene Kay Atkins |
First Address | Clinton, MO 64735-8804 |
Second Address | Clinton, MO 64735-8804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 10/01/2022 |