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CHASTITY HELENA HOLLIS
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1619475092
Individual Registrant: CHASTITY HELENA HOLLIS
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
5494 PONY EXPRESS TR CAMINO, CA 95709 US
Tel: 530-644-3758 Fax: --
Tel: 530-644-3758 Fax: --
Contact information for business:
5494 PONY EXPRESS TR CAMINO, CA 95709 US
Tel: 530-644-3758 Fax: --
Tel: 530-644-3758 Fax: --
Registration Information:
NPI: 1619475092
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 |
|---|---|---|---|
