Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1306353594 |
---|---|
Provider Name | Tina Janan |
First Address | Los Angeles, CA 90007-3033 |
Second Address | Los Angeles, CA 90043-1227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2018 |
Last Update Date | 01/03/2018 |