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1245750223
LISA MARIE HERTENSTEIN
MANTECA, CA
NPI
1245750223
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-06-21
Last Update Date
2017-06-21
Business Address
LISA MARIE HERTENSTEIN
955 W CENTER ST
MANTECA, CA 95337-7300
Phone number: 209-239-9600
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Mailing Address
LISA MARIE HERTENSTEIN
4814 HEARTHWOOD CT
STOCKTON, CA 95206-6305
Phone number: 209-601-2255
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