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NICK VALENTINE AVILA LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1639471485

Individual Registrant:
 NICK VALENTINE AVILA LCSW
Gender: M
Not Sole Proprietor

Location and contact information for practice:
209 E 7TH ST  MADERA, CA 93638-3780 US
Tel: 559-673-3508  Fax: --

Contact information for business:
209 E 7TH ST  MADERA, CA 93638-3780 US
Tel: 559-673-3508  Fax: --

Registration Information:
NPI: 1639471485
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
CA75883

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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