Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 6689 | NC |
NPI | 1003003039 |
---|---|
Provider Name | Mrs. Mary Muthoni Barine |
First Address | Wake Forest, NC 27587-9562 |
Second Address | Wake Forest, NC 27587-9562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 27/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6103715 | (05) | NC |