Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003008871 |
---|---|
Provider Name | Dione Taylor |
First Address | San Diego, CA 92113-2411 |
Second Address | San Diego, CA 92113-2411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 15/08/2007 |