Individual
ALISA LATRICE FLAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
769 W BLAINE ST STE A, RIVERSIDE, CA 92507-3970
(951) 358-6895
Mailing address
16433 GELDING WAY, MORENO VALLEY, CA 92555-3313
(951) 243-6906
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC 47888
CA
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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