Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1184149288 |
---|---|
Provider Name | Jill Timmer |
First Address | Alpine, CA 91901-2113 |
Second Address | Alpine, CA 91901-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2017 |
Last Update Date | 09/08/2017 |