Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003058918 |
---|---|
Provider Name | Raymond William Kieft II |
First Address | Santa Barbara, CA 93101-2426 |
Second Address | Santa Barbara, CA 93103-2714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2009 |
Last Update Date | 24/03/2009 |