Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC 15617 | AZ |
NPI | 1003296138 |
---|---|
Provider Name | Sanja Sobo |
First Address | Tempe, AZ 85282-5206 |
Second Address | Tempe, AZ 85282-5206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2015 |
Last Update Date | 15/06/2015 |