Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | CA | |
N | 174V00000X | Clinical Ethicist |
NPI | 1831726280 |
---|---|
Provider Name | Robin R Wells |
First Address | Lafayette, CA 94549-5010 |
Second Address | Lafayette, CA 94549-4524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2020 |
Last Update Date | 18/05/2021 |