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1821456658
LYNNGENIA CARRUTH
FAIRFIELD, CA
NPI
1821456658
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-02-08
Last Update Date
2016-02-08
Business Address
-- LYNNGENIA CARRUTH
1735 ENTERPRISE DR SUITE 105A
FAIRFIELD, CA 94533-6822
Phone number: 707-425-1799
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Mailing Address
-- LYNNGENIA CARRUTH
1735 ENTERPRISE DR SUITE 105A
FAIRFIELD, CA 94533-6822
Phone number: 707-425-1799
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