Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003449588 |
---|---|
Provider Name | Martha Elena Alcazar |
First Address | Fresno, CA 93721-2493 |
Second Address | Caruthers, CA 93609-9437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2020 |
Last Update Date | 12/02/2020 |