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Individual
JAMIE HERRERA
Active
Individual
JAMIE HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC10664
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032042
—
AZ
Enumeration date
06/24/2015
Last updated
02/26/2019
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