Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | CCMH0197371 | NM |
NPI | 1003249871 |
---|---|
Provider Name | Yasna Quiveors |
First Address | Sicklerville, NJ 08081-1112 |
Second Address | Ruidoso, NM 88345-6338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2013 |
Last Update Date | 22/06/2021 |