Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1235625211 |
---|---|
Provider Name | Azeen Nafisi |
First Address | Pasadena, CA 91105-3912 |
Second Address | Monrovia, CA 91016-3427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2018 |
Last Update Date | 04/02/2019 |