Individual
ALYSCIA ICARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 E MERCED ST, FOWLER, CA 93625-2316
(559) 776-8639
Mailing address
311 E MERCED ST, FOWLER, CA 93625-2316
(559) 776-8639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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