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Organization
SUSAN HAVERTY
Active
Organization
SUSAN HAVERTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN HAVERTY (COUNSELOR)
(916) 355-8721
Entity
Organization
Contact information
Practice address
3067 FREEPORT BLVD, SACRAMENTO, CA 95818-4347
(916) 355-8721
Mailing address
PO BOX 2842, RANCHO CORDOVA, CA 95741-2842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MFC44110
CA
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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