Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 94022135 | CA |
NPI | 1528376159 |
---|---|
Provider Name | Miss Christine L. Loupe |
First Address | Redlands, CA 92373-3119 |
Second Address | Redlands, CA 92373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2010 |
Last Update Date | 07/08/2019 |