Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1806 | AL |
NPI | 1003166315 |
---|---|
Provider Name | Susan Dijulio |
First Address | Auburn, AL 36830-3814 |
Second Address | Auburn, AL 36830-3814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 13/09/2012 |