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Latrina Wallace
Addiction (Substance Use Disorder) Counselor in Hesperia, California
NPI 1124581327

Latrina Wallace is an Addiction (Substance Use Disorder) Counselor based in Barstow, CA and is specialized in Addiction (Substance Use Disorder). Latrina Wallace practices in Hesperia, CA. The NPI Number for Latrina Wallace is 1124581327 and holds a License No. (California).

The current practice location address for Latrina Wallace is 11776 Mariposa Rd Ste 101, Hesperia, CA and can be reached out via phone at 760-956-2462.

Location: 11776 Mariposa Rd Ste 101, Hesperia, CA, 92311-5449
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124581327
Provider Name
Latrina Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
11776 Mariposa Rd Ste 101, Hesperia, CA, 92311-5449
Phone Number
760-956-2462
Fax Number
Provider Enumeration Date
04/13/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11776 Mariposa Rd Ste 101
City
Hesperia
State
California
Zip
92345-1622
Phone Number
760-956-2462
Fax Number
person
Provider Business Mailing Address Details
Address
11776 Mariposa Rd Ste 101
City
Hesperia
State
California
Zip
92345-1622
Phone Number
760-956-2462
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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