Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003148693 |
---|---|
Provider Name | Markesha Antonette Sanders |
First Address | Compton, CA 90222-3514 |
Second Address | Compton, CA 90222-3514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2010 |
Last Update Date | 05/02/2010 |