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CHASTITY HELENA HOLLIS

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

Registrant NPI Number: 1619475092

Individual Registrant:
 CHASTITY HELENA HOLLIS 
Gender: F
Sole Proprietor

Location and contact information for practice:
5494 PONY EXPRESS TR  CAMINO, CA 95709 US
Tel: 530-644-3758  Fax: --

Contact information for business:
5494 PONY EXPRESS TR  CAMINO, CA 95709 US
Tel: 530-644-3758  Fax: --

Registration Information:
NPI: 1619475092
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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