Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | SW1794I | AZ |
NPI | 1255471033 |
---|---|
Provider Name | Ms. Donna Jo Pisciotta |
First Address | Chandler, AZ 85225-4035 |
Second Address | Gilbert, AZ 85296-3437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
639289 | (05) | AZ |