Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | R1354440719 | CA |
NPI | 1003460163 |
---|---|
Provider Name | Ms. Kerrie Lynna Mcalister |
First Address | Fresno, CA 93728-3419 |
Second Address | Fresno, CA 93728-3419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2019 |
Last Update Date | 05/01/2022 |