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Individual
ERIN DEPUY LIESTMAN
Active
Individual
ERIN DEPUY LIESTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700919735
SAN DIEGO CENTER FOR CHILDREN
CA
01
—
1760431670
COMMUNITY AND SCHOOL BASED COUNSELING
CA
Enumeration date
10/11/2019
Last updated
08/10/2021
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