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1912360520
PA IA THOR
SACRAMENTO, CA
NPI
1912360520
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-03-31
Last Update Date
2016-03-31
Business Address
-- PA IA THOR
2100 CAPITOL AVE
SACRAMENTO, CA 95816-5721
Phone number: 916-442-4985
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Mailing Address
-- PA IA THOR
545 CAPE BRETON LN
TRACY, CA 95377-6641
Phone number: 920-277-4959
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