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1194374397
FAIRY MAE ALLEN
SACRAMENTO, CA
NPI
1194374397
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-09-10
Last Update Date
2019-09-10
Business Address
FAIRY MAE ALLEN
4343 WILLIAMSBOURGH DR
SACRAMENTO, CA 95823-2006
Phone number: 916-395-3552
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Mailing Address
FAIRY MAE ALLEN
7600 BIRDIE CT
SACRAMENTO, CA 95828-4802
Phone number: 916-825-9846
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