Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1225404189 |
---|---|
Provider Name | Tanya Avila |
First Address | Anaheim, CA 92805-6507 |
Second Address | Anaheim, CA 92805-6507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2015 |
Last Update Date | 14/08/2015 |