Healthcare Provider Details
I. General information
NPI: 1992837074
Provider Name (Legal Business Name): MISS ALLISON NICOLE DUCKWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1270 NATIVIDAD RD RM 200
SALINAS CA
93906-3122
US
IV. Provider business mailing address
951 BLANCO CIR STE B
SALINAS CA
93901-4451
US
V. Phone/Fax
- Phone: 831-755-4510
- Fax:
- Phone: 831-796-1648
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: