Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1083271738 |
---|---|
Provider Name | Mitchell Rae Spezzaferri |
First Address | Monrovia, CA 91016-3427 |
Second Address | Monrovia, CA 91016-3427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2019 |
Last Update Date | 21/11/2019 |