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1114049681
SHELLY D LAACK
STOCKTON, CA
NPI
1114049681
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-04
Last Update Date
2007-07-08
Business Address
Mrs. SHELLY D LAACK
620 N AURORA ST STE 1
STOCKTON, CA 95202-2276
Phone number: 209-468-3720
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Mailing Address
Mrs. SHELLY D LAACK
4322 LEGACY CT
STOCKTON, CA 95219-2506
Phone number: 209-468-3288
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