Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 99460 | CA |
N | 101YM0800X | Mental Health Counselor | 99460 | CA |
Y | 225C00000X | Rehabilitation Counselor | 99460 | CA |
NPI | 1144587619 |
---|---|
Provider Name | Ms. Selena Rebekah Weber |
First Address | Ukiah, CA 95482-2077 |
Second Address | Ukiah, CA 95482 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 14/09/2018 |