Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | 335538 | IA |
NPI | 1013370220 |
---|---|
Provider Name | Ms. Cynthia Pelton |
First Address | Sioux City, IA 51105-1207 |
Second Address | Sioux City, IA 51105-1207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 04/04/2016 |