Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 1232 | WV |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 841 | WV |
Y | 103TC1900X | Counseling Psychologist | 841 | WV |
NPI | 1023016920 |
---|---|
Provider Name | Ms. April Lynn House |
First Address | Keyser, WV 26726-3520 |
Second Address | Keyser, WV 26726-3520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 02/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9202116000 | (05) | WV |