Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC - 0788 | AZ |
NPI | 1003113143 |
---|---|
Provider Name | Mr. William Saunders |
First Address | Tempe, AZ 85282 |
Second Address | Tempe, AZ 85282-7628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2011 |
Last Update Date | 25/02/2011 |