Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 6401016810 | MI |
N | 101YS0200X | School Counselor | 6401016810 | MI |
NPI | 1205311859 |
---|---|
Provider Name | Ms. Felicicia Mcneill |
First Address | Southfield, MI 48034-1011 |
Second Address | Southfield, MI 48075-2036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2018 |
Last Update Date | 24/07/2019 |