Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1285941526 |
---|---|
Provider Name | Yolanda Chavez |
First Address | Glendale, CA 91205-2575 |
Second Address | Los Angeles, CA 90066-3840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 09/08/2013 |