Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 1132225 | NC |
NPI | 1053888313 |
---|---|
Provider Name | Mrs. Kristine B Keith |
First Address | Oak Island, NC 28465-5922 |
Second Address | Oak Island, NC 28465-5922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2018 |
Last Update Date | 25/10/2018 |