Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 3382048 | AZ |
NPI | 1023203809 |
---|---|
Provider Name | Mrs. Stephanie Lynn Prestwich |
First Address | Show Low, AZ 85901-6351 |
Second Address | Show Low, AZ 85901-4608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 13/09/2007 |