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General NPI Number Information
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NPI Number | 1740732866
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Entity Type | Individual
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Provider Name | MRS. ALEYA KARENTON WILLIS
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 10410 GRAND FIR RD
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City | CHARLOTTE
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State | NC
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Zip | 28227-3691
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Country | US
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Telephone | 678-468-6532
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Fax |
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Provider Business Mailing Address
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Address Line | 10410 GRAND FIR RD
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City | CHARLOTTE
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State | NC
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Zip | 28227-3691
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Country | US
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Telephone | 678-468-6532
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | SC0000000895913
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License Number State | MI
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