Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 82429 | TX |
NPI | 1003578576 |
---|---|
Provider Name | Sally Elizabeth Spiller |
First Address | Denton, TX 76209-1104 |
Second Address | Denton, TX 76209-1104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2021 |
Last Update Date | 12/10/2021 |