Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1225671704 |
---|---|
Provider Name | Kendall Fitzpatrick |
First Address | La Mesa, CA 91942-7420 |
Second Address | Oceanside, CA 92057-2646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2019 |
Last Update Date | 09/11/2021 |