Individual
ASHLEY LACY ANGANU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N ARROWHEAD AVE, SAN BERNARDINO, CA 92401-1164
(909) 963-5355
Mailing address
600 N ARROWHEAD AVE, SAN BERNARDINO, CA 92401-1164
(909) 963-5355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6809-R
CA
101YM0800X
Mental Health Counselor
Primary
110578
CA
101YM0800X
Mental Health Counselor
74626
CA
1041C0700X
Clinical Social Worker
ASW74626
CA
Other
Enumeration date
07/09/2015
Last updated
10/17/2022
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