Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 31731 | CA |
NPI | 1003162397 |
---|---|
Provider Name | Kara Rae Kazemba |
First Address | Hillsboro, OR 97123-3991 |
Second Address | Hillsboro, OR 97123-3991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2012 |
Last Update Date | 01/12/2021 |