Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003090853 |
---|---|
Provider Name | Maria Antonia Q Respall |
First Address | Sacramento, CA 95815-1412 |
Second Address | Sacramento, CA 95815-1412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 12/04/2011 |