Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003192873 |
---|---|
Provider Name | Maydy Bran-Orona |
First Address | Glendora, CA 91741-3559 |
Second Address | Pomona, CA 91767-5407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2011 |
Last Update Date | 25/10/2011 |