Individual
TORI SAN INOCENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
1450 ROSS CLARK CIR, DOTHAN, AL 36301-4765
(334) 794-2113
Mailing address
1450 ROSS CLARK CIR, DOTHAN, AL 36301-4765
(334) 794-2113
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC05352
AL
101YP2500X
Professional Counselor
Primary
LPC05352
AL
Other
Enumeration date
02/21/2022
Last updated
11/13/2024
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