Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1154495166 |
---|---|
Provider Name | Mrs. Laura Patricia Reyes |
First Address | Chula Vista, CA 91911-1352 |
Second Address | Chula Vista, CA 91911-1352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 29/03/2011 |