Individual
AILEEN KATHLEEN GAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 S LENORE AVE # B, WILLITS, CA 95490-3632
(707) 456-3820
Mailing address
221 B SOUTH LENORE ST., WILLITS, CA 95490
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CATC# 061326
CA
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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