Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 101YS0200X | School Counselor | ||
N | 104100000X | Social Worker | ||
N | 1041S0200X | School Social Worker |
NPI | 1356775548 |
---|---|
Provider Name | Shirley Gattis |
First Address | Sierra Vista, AZ 85635-5732 |
Second Address | Sierra Vista, AZ 85635-5732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2013 |
Last Update Date | 24/08/2013 |