Doctor Name: | MISS DEALLY S. LIM |
NPI Number: | 1043536246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 885 W 18th St Merced, CA - 953404604 |
Business Phone Number: | 2097263090 |
Business Fax Number: | |
Mailing Address: | 1225 Crater Ave, MODESTO |
State: | CA |
Postal Code: | 953517312 |
Phone Number: | 2099684987 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2010 |
NPI Last Update Date: | 09/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |