Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 4036915 | AZ |
NPI | 1134451339 |
---|---|
Provider Name | Ms. Vasantha Munoz |
First Address | Bullhead City, AZ 86442-5946 |
Second Address | Bullhead City, AZ 86442-5946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2010 |
Last Update Date | 12/02/2010 |