Individual
MARY ALLIKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
29196 AUBERRY RD, PRATHER, CA 93651
(805) 400-9192
Mailing address
29196 AUBERRY RD, PRATHER, CA 93651
(805) 400-9192
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
31644
CA
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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