Doctor Name: | MRS. REBECA P. WILLIS |
NPI Number: | 1689726051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,MFT |
License Number: | MFCT 13018 |
Business Practice Address: | 2304 Huntington Dr 254 San Marino, CA - 911082649 |
Business Phone Number: | 6269439193 |
Business Fax Number: | |
Mailing Address: | 1000 Darby Rd, SAN MARINO |
State: | CA |
Postal Code: | 911082425 |
Phone Number: | 6269439193 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MFCT 13018 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |