Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | T-CTL0196441 | NM |
NPI | 1003211491 |
---|---|
Provider Name | Whitney Wozniak |
First Address | Albuquerque, NM 87111-7386 |
Second Address | Albuquerque, NM 87102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2014 |
Last Update Date | 06/06/2018 |