Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 14967 | TX |
N | 103TS0200X | School Psychologist | 32131 | TX |
NPI | 1043339161 |
---|---|
Provider Name | Stephanie Ann Dawdy |
First Address | Canyon, TX 79015-0131 |
Second Address | Canyon, TX 79015-3839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |