Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPCC8593 | CA |
NPI | 1003321761 |
---|---|
Provider Name | Elizabeth Tracy Cappel-Rice |
First Address | Clovis, CA 93619-3729 |
Second Address | Fresno, CA 93711-2063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2017 |
Last Update Date | 28/12/2020 |