Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003420985 |
---|---|
Provider Name | Delia Marie Rosales |
First Address | Bakersfield, CA 93302-1559 |
Second Address | Lamont, CA 93241-1953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 16/12/2021 |