Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 068-0000706 | VT |
NPI | 1003035601 |
---|---|
Provider Name | Rebecca Fitton |
First Address | Lansing, MI 48917-3541 |
Second Address | Lansing, MI 48917-3541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 22/11/2016 |