Individual
ELAINA EALYCORASMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1735 ENTERPRISE DR, SUITE 105A BLDG.1, FAIRFIELD, CA 94533-6822
(707) 425-1799
Mailing address
2534 SAN FERNANDO WAY, APRT. 2, SACRAMENTO, CA 95818-2759
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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