Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | LPC-11002 | AZ |
NPI | 1164555868 |
---|---|
Provider Name | Shari Brown |
First Address | Tucson, AZ 85745-2326 |
Second Address | Tucson, AZ 85745-2326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
824244 | (05) | AZ |