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ASHADIEEYAH LATIFA KARIMA BARAKAT
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1285103200
Individual Registrant: ASHADIEEYAH LATIFA KARIMA BARAKAT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
441 S HAM LN STE A LODI, CA 95242-3525 US
Tel: 209-224-8940 Fax: --
Tel: 209-224-8940 Fax: --
Contact information for business:
441 S HAM LN STE A LODI, CA 95242-3525 US
Tel: 209-244-8940 Fax: --
Tel: 209-244-8940 Fax: --
Registration Information:
NPI: 1285103200
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
