Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 2013004250 | MO |
N | 101YM0800X | Mental Health Counselor | 2013004250 | MO |
Y | 101YP2500X | Professional Counselor | 2013004250 | MO |
N | 101YS0200X | School Counselor | 2013004250 | MO |
NPI | 1124448386 |
---|---|
Provider Name | Tina Howe |
First Address | Bloomsdale, MO 63627-9038 |
Second Address | Bloomsdale, MO 63627-9038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2014 |
Last Update Date | 25/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2013004250 | (05) | MO |