Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 4745 | NC |
NPI | 1003912262 |
---|---|
Provider Name | Ms. Holly Eve Yates |
First Address | Raleigh, NC 27609-6621 |
Second Address | Raleigh, NC 27615-6017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
140X6 BCBSNC | LPC (01) | NC |
359258 MHN | LPC (01) | NC |
6102262 | (05) | NC |