Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 16107 | LA |
NPI | 1003403932 |
---|---|
Provider Name | Fabienne Joseph-Myers |
First Address | Los Angeles, CA 90073-1003 |
Second Address | Los Angeles, CA 90073-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2020 |
Last Update Date | 27/12/2020 |