Individual provider · Type 1 NPI
Mallie Fernacia Latham
Addiction (Substance Use Disorder) Counselor · Vallejo, CA
NPI number
1881879534
Active
Practice location
325 Ohio St
Vallejo, CA 94590-5052
Fax (415) 928-3710
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1881879534
Mallie Fernacia Latham's National Provider Identifier is 1881879534, issued on Dec 31, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vallejo, CA. The record was last updated on Jan 19, 2016.