Individual
MRS. BETTY GENE THOMPSON-LARKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTT
Contact information
Practice address
245 N MURRAY ST, BANNING, CA 92220-5528
(951) 663-8366
Mailing address
1482 N CLIFFORD AVE APT 1, RIALTO, CA 92376-3322
(909) 648-3002
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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