Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 36759 | TX |
NPI | 1114329984 |
---|---|
Provider Name | Dr. Michele Audrey Ocen |
First Address | Los Angeles, CA 90013-1357 |
Second Address | Orange, CA 92868-4231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2014 |
Last Update Date | 23/09/2014 |