Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1275786873 |
---|---|
Provider Name | Miss Cynthia Jayne Souza |
First Address | Paradise, CA 95969-3280 |
Second Address | Paradise, CA 95969-3280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |