Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 693 | CA |
N | 225C00000X | Rehabilitation Counselor | 00116134 | GA |
NPI | 1336542422 |
---|---|
Provider Name | Mr. Donald Essex |
First Address | Culver City, CA 90230-4820 |
Second Address | Los Angeles, CA 90035-2520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 02/10/2014 |