Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003162694 |
---|---|
Provider Name | Mrs. Kari Rostron |
First Address | Gridley, CA 95948-2128 |
Second Address | Gridley, CA 95948-2128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 01/08/2012 |