Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401014646 | MI |
NPI | 1003207648 |
---|---|
Provider Name | Mrs. Sanitha Pulikkotil |
First Address | Auburn Hills, MI 48326-4165 |
Second Address | Mount Clemens, MI 48043-1562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2015 |
Last Update Date | 12/05/2015 |