Individual provider · Type 1 NPI
Phillip Shack Utumapu, RAS
Addiction (Substance Use Disorder) Counselor · Yucaipa, CA
NPI number
1962834721
Active
Practice location
13626 Holmes St Apt 16
Yucaipa, CA 92399-5567
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Other addiction (substance use disorder) counselor providers in Yucaipa
About NPI 1962834721
Phillip Shack Utumapu, RAS's National Provider Identifier is 1962834721, issued on Aug 5, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Yucaipa, CA. The record was last updated on Aug 5, 2013.