Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | F1008141131 | CA |
NPI | 1003173535 |
---|---|
Provider Name | Andrea Faldon |
First Address | Hanford, CA 93230-3638 |
Second Address | Hanford, CA 93230-3638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2012 |
Last Update Date | 22/04/2012 |