Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003058231 |
---|---|
Provider Name | Sanaz Ghorbanpoor |
First Address | Juneau, AK 99801-9501 |
Second Address | Juneau, AK 99801-9501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 02/04/2009 |