Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ASW26682 | CA |
NPI | 1003070517 |
---|---|
Provider Name | Kathy Metoyer |
First Address | Sacramento, CA 95825-4500 |
Second Address | Sacramento, CA 95825-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2008 |
Last Update Date | 29/12/2009 |