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1184080319
LIZETTE IBANEZ
MODESTO, CA
NPI
1184080319
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2016-01-04
Last Update Date
2022-08-15
Business Address
LIZETTE IBANEZ
800 SCENIC DR
MODESTO, CA 95350-6131
Phone number: 209-287-6431
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Mailing Address
LIZETTE IBANEZ
420 E CANAL DR
TURLOCK, CA 95380-3936
Phone number:
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