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1104948595
AGNES HELEN MADAVE
STOCKTON, CA
NPI
1104948595
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA pt28610)
Enumeration Date
2007-04-04
Last Update Date
2007-07-08
Business Address
Mrs. AGNES HELEN MADAVE psych tech
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8880
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Mailing Address
Mrs. AGNES HELEN MADAVE psych tech
1212 N. CALIFORNIA
STOCKTON, CA 95202
Phone number: 209-468-8880
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