JENNIE LANE L BICKNELL

SAN RAFAEL, CA
NPI1396579611
Former NameJENNIE LANE BICKNELL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1518840823)
Enumeration Date2024-08-28
Last Update Date2024-08-28
Business Address
JENNIE LANE L BICKNELL RADT
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-454-9444
Mailing Address
JENNIE LANE L BICKNELL RADT
1208 SIR FRANCIS DRAKE BLVD APT 4
SAN ANSELMO, CA 94960-1745
Phone number: 415-250-2761