Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | RI-T0606140923 |
NPI | 1013037928 |
---|---|
Provider Name | Ms. Dori J Truax |
First Address | Windsor, CA 95492 |
Second Address | Santa Rosa, CA 95401-4282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |