Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 0777 | KY |
Y | 101Y00000X | Counselor | 2035 | WV |
NPI | 1003165879 |
---|---|
Provider Name | Sonnee Da'niel Stanley |
First Address | Princeton, WV 24740-2329 |
Second Address | Princeton, WV 24740-2329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2012 |
Last Update Date | 07/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005489001 | (05) | WV |
0005489002 | (05) | WV |