Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 69285 | TX |
NPI | 1003295742 |
---|---|
Provider Name | Mrs. Alicia Ceynar |
First Address | Euless, TX 76039-8630 |
Second Address | Arlington, TX 76016-2793 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2015 |
Last Update Date | 31/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
363484202 | (05) | TX |