Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 225XM0800X | Mental Health |
NPI | 1093163644 |
---|---|
Provider Name | Andrea Lemus |
First Address | Palm Desert, CA 92260-2879 |
Second Address | Palm Desert, CA 92260-3939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2016 |
Last Update Date | 07/09/2016 |