Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003062308 |
---|---|
Provider Name | Carol Ann Kays |
First Address | Crescent City, CA 95531-8301 |
Second Address | Crescent City, CA 95531-8301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 18/08/2008 |