Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003062761 |
---|---|
Provider Name | Patricia Kem |
First Address | Blythe, CA 92225 |
Second Address | Blythe, CA 92225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2008 |
Last Update Date | 08/06/2009 |