Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1043503345 |
---|---|
Provider Name | Erick Emms |
First Address | Escondido, CA 92026-3043 |
Second Address | Escondido, CA 92026-3043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 18/05/2011 |