Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YM0800X | Mental Health Counselor | 2716 | MS |
N | 101YS0200X | School Counselor |
NPI | 1073277737 |
---|---|
Provider Name | Raina Deer |
First Address | Clinton, MS 39056-6087 |
Second Address | Clinton, MS 39056-6087 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2021 |
Last Update Date | 28/10/2021 |