MALLIE FERNACIA LATHAM

VALLEJO, CA
NPI1881879534
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-12-31
Last Update Date2016-01-19
Business Address
-- MALLIE FERNACIA LATHAM
325 OHIO ST
VALLEJO, CA 94590-5052
Phone number: 415-928-7800
Mailing Address
-- MALLIE FERNACIA LATHAM
325 OHIO ST
VALLEJO, CA 94590-5052
Phone number: 415-928-7800
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