Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP2500X | Professional Counselor | ||
Y | 101YS0200X | School Counselor |
NPI | 1033588389 |
---|---|
Provider Name | Mrs. Brooke Dotterer-Mendez |
First Address | Rawlins, WY 82301-4421 |
Second Address | Rawlins, WY 82301-4556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2015 |
Last Update Date | 16/09/2015 |