Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 39001412A | IN |
N | 101YS0200X | School Counselor | 87000623A | IN |
NPI | 1093064453 |
---|---|
Provider Name | Shannon O'hara |
First Address | Indianapolis, IN 46256-4649 |
Second Address | Indianapolis, IN 46250-2040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 29/08/2013 |