Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | CA | |
N | 101YS0200X | School Counselor | CA | |
N | 104100000X | Social Worker | CA | |
N | 225C00000X | Rehabilitation Counselor | CA |
NPI | 1245376474 |
---|---|
Provider Name | Mrs. Amy Sofer Bromelow |
First Address | Paradise, CA 95967-1476 |
Second Address | Paradise, CA 95969-3280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 05/06/2012 |