Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1083188015 |
---|---|
Provider Name | Colleen Beth Hargett |
First Address | Hesperia, CA 92344-8231 |
Second Address | Hesperia, CA 92344-8231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2019 |
Last Update Date | 12/01/2019 |