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1891852661
LISA VINE
STOCKTON, CA
NPI
1891852661
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS22813)
Enumeration Date
2007-01-02
Last Update Date
2022-01-03
Business Address
-- LISA VINE LCSW
1305 TOMMYDON ST
STOCKTON, CA 95210-3364
Phone number: 209-476-5490
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Mailing Address
-- LISA VINE LCSW
1305 TOMMYDON ST
STOCKTON, CA 95210-3364
Phone number: 209-476-5490
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