THERESA PORTER

FAIRFIELD, CA
NPI1659138147
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1518650823)
Enumeration Date2024-03-01
Last Update Date2024-03-01
Business Address
THERESA PORTER RADT
1225 TRAVIS BLVD
FAIRFIELD, CA 94533-4892
Phone number: 707-399-9105
Mailing Address
THERESA PORTER RADT
609 JEFFERSON ST
FAIRFIELD, CA 94533-6293
Phone number: 916-759-3023