Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 69215 | TX |
NPI | 1003217308 |
---|---|
Provider Name | Paula Nicholas Storrer |
First Address | Austin, TX 78703-4321 |
Second Address | Austin, TX 78703-4321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2014 |
Last Update Date | 06/09/2014 |