Individual
CASSANDRA R COLVIN
Active
Individual
CASSANDRA R COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT-1
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D3960130
DRIVER LICENSE
CA
Enumeration date
08/29/2018
Last updated
02/07/2020
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