Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003156290 |
---|---|
Provider Name | Ms. Katherine Anne Sturgis |
First Address | Conyers, GA 30012-4339 |
Second Address | Lawrenceville, GA 30046-8444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2013 |
Last Update Date | 25/02/2013 |