Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 058824-1 |
NPI | 1205365640 |
---|---|
Provider Name | Ms. Esther Pearl Jackson |
First Address | Albany, NY 12203-1601 |
Second Address | Albany, NY 12203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 08/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
058824-1 | (05) | NY |