Individual
BEVERLY NKEMDIRIM OMOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 TRAILSIDE CIR, CONCORD, CA 94518-2184
(562) 405-5215
Mailing address
1211 TRAILSIDE CIR, CONCORD, CA 94518-2184
(562) 405-5215
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225X00000X
Occupational Therapist
Primary
11599
CA
Other
Enumeration date
04/07/2007
Last updated
04/15/2022
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