Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003160334 |
---|---|
Provider Name | Latoya Duke |
First Address | Sacramento, CA 95823-2652 |
Second Address | Sacramento, CA 95823-2652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2012 |
Last Update Date | 08/11/2012 |