Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003140468 |
---|---|
Provider Name | Mrs. Yverose De St. Pierre |
First Address | Covington, GA 30016-3317 |
Second Address | Covington, GA 30016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2009 |
Last Update Date | 01/10/2009 |