Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003146416 |
---|---|
Provider Name | Goleania Cheric Darrett |
First Address | Chula Vista, CA 91913-1485 |
Second Address | Ontario, CA 91764-4898 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2010 |
Last Update Date | 17/12/2018 |