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1770018962
CHARLENE CONWAY
FAIRFIELD, CA
NPI
1770018962
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA 40381)
Enumeration Date
2017-04-25
Last Update Date
2017-04-25
Business Address
-- CHARLENE CONWAY LPT
2101 COURAGE DR
FAIRFIELD, CA 94533-6717
Phone number: 707-639-4675
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Mailing Address
-- CHARLENE CONWAY LPT
2101 COURAGE DR
FAIRFIELD, CA 94533-6717
Phone number: 707-639-4675
Copy
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