Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 64789 | TX |
Y | 101YS0200X | School Counselor | 64789 | TX |
NPI | 1043503998 |
---|---|
Provider Name | Mrs. Dorothy Elaine Charles |
First Address | Sugar Land, TX 77478-3144 |
Second Address | Sugar Land, TX 77478-3144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 25/05/2011 |