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1154963916
LACI PRATHER
MODESTO, CA
NPI
1154963916
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-10-14
Last Update Date
2019-10-14
Business Address
LACI PRATHER Radt1
1405 11TH ST
MODESTO, CA 95354-0748
Phone number: 209-284-0970
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Mailing Address
LACI PRATHER Radt1
1030 CALIFORNIA AVE
MODESTO, CA 95351-2102
Phone number: 209-735-1133
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