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KATHLEEN MAY BROONER RAS
>> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1639370505
Individual Registrant: KATHLEEN MAY BROONER RAS
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
675 1ST ST UPPER LAKE, CA 95485-9586 US
Tel: 707-275-0506 Fax: --
Tel: 707-275-0506 Fax: --
Contact information for business:
PO BOX 2077 UKIAH, CA 95482-2077 US
Tel: 707-467-2010 Fax: --
Tel: 707-467-2010 Fax: --
Registration Information:
NPI: 1639370505
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101Y00000X | Behavioral Health & Social Service Providers Counselor | ||
| N | 171M00000X | Other Service Providers Case Manager/Care Coordinator | ||
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
