Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ASW31258 | CA |
NPI | 1003141268 |
---|---|
Provider Name | Luisana Marquez |
First Address | Pasadena, CA 91103-1620 |
Second Address | Pasadena, CA 91103-1620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2009 |
Last Update Date | 01/05/2013 |