Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MFT MN15479 | CA |
NPI | 1003078940 |
---|---|
Provider Name | Dr. Patricia Minnitti |
First Address | Lomita, CA 90717-3724 |
Second Address | Lomita, CA 90717-3724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 01/07/2008 |