Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YS0200X | School Counselor |
NPI | 1154578375 |
---|---|
Provider Name | Kimberly White |
First Address | Los Angeles, CA 90034-3710 |
Second Address | Los Angeles, CA 90034-3710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 14/06/2013 |