Individual provider · Type 1 NPI
Tama Marie McKibbin
Addiction (Substance Use Disorder) Counselor · Santa Rosa, CA
NPI number
1578735650
Active
Practice location
1901 Cleveland Ave, #B, Santa Rosa Treatment Program
Santa Rosa, CA 95401
Fax (707) 576-7845
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | RI-M1301282236 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1578735650
Tama Marie McKibbin's National Provider Identifier is 1578735650, issued on Mar 28, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Santa Rosa, CA. The record was last updated on Aug 19, 2013.