person
Mallie Fernacia Latham
Addiction (Substance Use Disorder) Counselor in Vallejo, California
NPI 1881879534

Mallie Fernacia Latham is an Addiction (Substance Use Disorder) Counselor based in Vallejo, CA and is specialized in Addiction (Substance Use Disorder). Mallie Fernacia Latham practices in Vallejo, CA. The NPI Number for Mallie Fernacia Latham is 1881879534 and holds a License No. (California).

The current practice location address for Mallie Fernacia Latham is 325 Ohio St, Vallejo, CA and can be reached out via phone at 415-928-7800 and via fax at 415-928-3710.

Location: 325 Ohio St, Vallejo, CA, 94590-5052
person
Provider Profile Details
NPI Number
1881879534
Provider Name
Mallie Fernacia Latham
Credential
Provider Entity Type
Individual
Gender
Male
Address
325 Ohio St, Vallejo, CA, 94590-5052
Phone Number
415-928-7800
Fax Number
415-928-3710
Provider Enumeration Date
12/31/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
325 Ohio St
City
State
Zip
94590-5052
Phone Number
415-928-7800
Fax Number
415-928-3710
person
Provider Business Mailing Address Details
Address
325 Ohio St
City
State
Zip
94590-5052
Phone Number
415-928-7800
Fax Number
415-928-3710
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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