Doctor Name: | EDWARD A. PALMER |
NPI Number: | 1396117297 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MFTI |
License Number: | IMF73724 |
Business Practice Address: | 2750 Evensong Way Unit B Cambria, CA - 934284326 |
Business Phone Number: | 8054408598 |
Business Fax Number: | |
Mailing Address: | 2750 Evensong Way Unit B, CAMBRIA |
State: | CA |
Postal Code: | 934284326 |
Phone Number: | 8054408598 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2015 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | IMF73724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |