Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003100041 |
---|---|
Provider Name | Miss Lena Yesowitch |
First Address | San Francisco, CA 94127-1314 |
Second Address | Salem, OR 97304-3822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2011 |
Last Update Date | 07/06/2011 |