Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 14853 | CA |
NPI | 1316383177 |
---|---|
Provider Name | Miss Kathleen Marie Holford |
First Address | Torrance, CA 90502-1029 |
Second Address | Torrance, CA 90502-1029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 12/02/2015 |