Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS18561 | CA |
NPI | 1003013418 |
---|---|
Provider Name | Ms. Janie Michaels Grauman |
First Address | Los Angeles, CA 90036-2517 |
Second Address | Los Angeles, CA 90036-2517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 08/07/2007 |