Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 104100000X | Social Worker | ||
N | 225400000X | Rehabilitation Practitioner |
NPI | 1053647453 |
---|---|
Provider Name | Marisol Elizarraras |
First Address | Chula Vista, CA 91910-3711 |
Second Address | Chula Vista, CA 91910-3711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2009 |
Last Update Date | 05/07/2016 |