Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CA |
NPI | 1003481243 |
---|---|
Provider Name | Ms. Ashley Amy May Pickard |
First Address | Lompoc, CA 93436-6033 |
Second Address | Lompoc, CA 93436-6033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2021 |
Last Update Date | 20/05/2021 |