Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 3905654 | AZ |
NPI | 1215121348 |
---|---|
Provider Name | Ms. Tristan Marie Lujan |
First Address | Yuma, AZ 85364-2973 |
Second Address | Yuma, AZ 85364-2973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 31/08/2007 |