Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCI04200315 | CA |
NPI | 1003038357 |
---|---|
Provider Name | Toby Ann Reusze |
First Address | Yreka, YREKA 96097 |
Second Address | Yreka, CA 96097-9538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 19/07/2016 |