Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 104100000X | Social Worker |
NPI | 1003154451 |
---|---|
Provider Name | Mrs. Ashira Windsor |
First Address | Gulfport, MS 39501-2741 |
Second Address | Gulfport, MS 39501-2741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2013 |
Last Update Date | 09/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
56CC | ASPIRA (01) | CA |