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ASHADIEEYAH LATIFA KARIMA BARAKAT

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1285103200

Individual Registrant:
 ASHADIEEYAH LATIFA KARIMA BARAKAT 
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: --

Contact information for business:
441 S HAM LN STE A  LODI, CA 95242-3525 US
Tel: 209-244-8940  Fax: --

Registration Information:
NPI: 1285103200
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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