Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | RPS-2012463 | CA |
NPI | 1164624672 |
---|---|
Provider Name | Georgina Parra Morris |
First Address | Culver City, CA 90230-4820 |
Second Address | Inglewood, CA 90301-4502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 20/11/2014 |