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1285820472
TANISHA ANNETTE ERVIN
STOCKTON, CA
NPI
1285820472
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-09-20
Last Update Date
2007-09-20
Business Address
-- TANISHA ANNETTE ERVIN
8626 LOWER SACRAMENTO RD SUITE 41
STOCKTON, CA 95210-1835
Phone number: 209-478-2487
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Mailing Address
-- TANISHA ANNETTE ERVIN
8626 LOWER SACRAMENTO RD SUITE 41
STOCKTON, CA 95210-1835
Phone number: 209-478-2487
Copy
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