Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003144312 |
---|---|
Provider Name | Brenda Crouthers |
First Address | Santa Clarita, CA 91350-2991 |
Second Address | Long Beach, CA 90806-4312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2009 |
Last Update Date | 24/11/2009 |