Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1114344116 |
---|---|
Provider Name | Rachel Anderson |
First Address | Wabash, IN 46992-9162 |
Second Address | Kokomo, IN 46902-9613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 27/03/2014 |