Doctor Name: | MISS KIM ANN EGEL |
NPI Number: | 1174654925 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFT |
License Number: | 45827 |
Business Practice Address: | 2047 San Elijo Ave Cardiff, CA - 920071726 |
Business Phone Number: | 7602744649 |
Business Fax Number: | |
Mailing Address: | 510 N Rios Ave, SOLANA BEACH |
State: | CA |
Postal Code: | 920751246 |
Phone Number: | 7602744649 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 03/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 45827 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |