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General NPI Number Information
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NPI Number | 1407160500
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Entity Type | Organization
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Legal Business Name | OTHERS INTERNATIONAL, INC.
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 320 N E ST 107
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City | SAN BERNARDINO
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State | CA
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Zip | 92401-1540
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Country | US
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Telephone | 909-649-7261
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Fax |
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Provider Business Mailing Address
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Address Line | 11171 OAKWOOD DR K406
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City | LOMA LINDA
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State | CA
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Zip | 92354-4802
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Country | US
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Telephone | 909-649-7261
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Fax | 909-796-2537
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. SHIRLEY HUNT WIGGINS
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Credential |
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Telephone | 909-649-7261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCS20457
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License Number State | CA
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