Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | $$$$$$$$$ | NC |
NPI | 1003329194 |
---|---|
Provider Name | Mr. Gabriel Rosenboro |
First Address | Grifton, NC 28530-8628 |
Second Address | Raleigh, NC 27610-3033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2017 |
Last Update Date | 10/11/2017 |