Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | NV | |
N | 101YP1600X | Pastoral Counselor | 83537 | NV |
NPI | 1205364627 |
---|---|
Provider Name | Shirley Ann Albritton |
First Address | Las Vegas, NV 89108-4477 |
Second Address | Las Vegas, NV 89108-8910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2017 |
Last Update Date | 15/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1402652846 | LICENSE (01) | NV |