Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 22086 | CA |
NPI | 1003182742 |
---|---|
Provider Name | Ms. Gayle Ann Brohner |
First Address | Sherman Oaks, CA 91401-5320 |
Second Address | Sherman Oaks, CA 91401-5320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 27/03/2012 |