Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPCC3919 | CA |
NPI | 1003213091 |
---|---|
Provider Name | Natasha Brooke Bryson |
First Address | Los Angeles, CA 90007-4203 |
Second Address | Los Angeles, CA 90007-4203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2014 |
Last Update Date | 05/09/2017 |