Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 7081 | NC |
N | 101YM0800X | Mental Health Counselor | 7081 | NC |
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP2500X | Professional Counselor | 7081 | NC |
N | 101YS0200X | School Counselor | 7081 | NC |
NPI | 1306095781 |
---|---|
Provider Name | Mrs. Kimberly Lynn Comeau |
First Address | Swannanoa, NC 28778-2859 |
Second Address | Clyde, NC 28721-6540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2008 |
Last Update Date | 10/09/2008 |