Doctor Name: | PATRICIA GAIL LARAMORE |
NPI Number: | 1174773782 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2049 Skyline Dr Lemon Grove, CA - 919454221 |
Business Phone Number: | 6194657303 |
Business Fax Number: | |
Mailing Address: | 530 Graves Ave Apt 23, EL CAJON |
State: | CA |
Postal Code: | 920203652 |
Phone Number: | 6193289679 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2008 |
NPI Last Update Date: | 09/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |