Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 1479359 | AZ |
NPI | 1023336401 |
---|---|
Provider Name | Mr. Bruce Orrian Steele |
First Address | Flagstaff, AZ 86004-7794 |
Second Address | Flagstaff, AZ 86004-7794 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2010 |
Last Update Date | 11/05/2010 |