Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1144693706 |
---|---|
Provider Name | Torie Waite |
First Address | Henderson, NV 89014-7631 |
Second Address | Henderson, NV 89014-7631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2015 |
Last Update Date | 04/11/2015 |