Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 830 | AK |
Y | 101YP2500X | Professional Counselor | 830 | AK |
N | 101YS0200X | School Counselor | 4051697 | AK |
NPI | 1003231739 |
---|---|
Provider Name | Susan E Stanton |
First Address | Fairbanks, AK 99709-3639 |
Second Address | Fairbanks, AK 99709-3639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2014 |
Last Update Date | 17/03/2014 |