Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1328 | MS |
N | 101YS0200X | School Counselor | 198544 | MS |
NPI | 1164785689 |
---|---|
Provider Name | Shontia Vash'e Morris |
First Address | Jackson, MS 39211-2835 |
Second Address | Jackson, MS 39211-5930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 20/06/2012 |