Individual
ADRIENNE LACOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1477 LINCOLN AVE, SAN RAFAEL, CA 94901-2028
(415) 459-2395
Mailing address
120 REDWOOD AVE APT 6, CORTE MADERA, CA 94925-1466
(415) 847-9846
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10352
CA
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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