Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ASW 37064 | CA |
NPI | 1003248303 |
---|---|
Provider Name | Guadalupe Rodarte |
First Address | Visalia, CA 93278-5091 |
Second Address | Farmersville, CA 93223-1868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2013 |
Last Update Date | 18/11/2013 |