Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1194254615 |
---|---|
Provider Name | Rui Zhe Song |
First Address | Pasadena, CA 91107-3406 |
Second Address | Rosemead, CA 91770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 19/07/2021 |