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HAILEY ANN CHOATE SUDRC

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

Registrant NPI Number: 1992219620

Individual Registrant:
 HAILEY ANN CHOATE SUDRC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3 MARCELA DR STE C  WILLITS, CA 95490-5769 US
Tel: 707-459-6115  Fax: --

Contact information for business:
1120 S DORA ST  UKIAH, CA 95482-6340 US
Tel: 707-472-2637  Fax: --

Registration Information:
NPI: 1992219620
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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