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1962265041
MICKENSEY LYNN OLIVEIRA
MODESTO, CA
NPI
1962265041
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-02-01
Last Update Date
2024-02-01
Business Address
MICKENSEY LYNN OLIVEIRA
416 CORSON AVE
MODESTO, CA 95350-5408
Phone number: 209-521-1805
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Mailing Address
MICKENSEY LYNN OLIVEIRA
416 CORSON AVE
MODESTO, CA 95350-5408
Phone number: 209-521-1805
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