Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1073714556 |
---|---|
Provider Name | Ernest Mcrae |
First Address | Los Angeles, CA 90061-2730 |
Second Address | Los Angeles, CA 90061-2730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 08/07/2007 |