Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | CA |
NPI | 1265043343 |
---|---|
Provider Name | Rachel Rugh Fraser |
First Address | Torrance, CA 90508-0488 |
Second Address | Torrance, CA 90502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2020 |
Last Update Date | 28/09/2021 |