Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003168352 |
---|---|
Provider Name | Taeer Mina Maymon |
First Address | San Francisco, CA 94102-5144 |
Second Address | San Francisco, CA 94102-5144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2012 |
Last Update Date | 11/10/2012 |