Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003249665 |
---|---|
Provider Name | Kayla Quadros |
First Address | Swansea, MA 02777-4119 |
Second Address | Fall River, MA 02720-2983 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2013 |
Last Update Date | 17/08/2013 |