Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1215574181 |
---|---|
Provider Name | Breann Nicole Sumser |
First Address | View Park, CA 90043-1648 |
Second Address | View Park, CA 90043-1648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2019 |
Last Update Date | 10/12/2019 |