Individual
ANDI M GLETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCII A3773397
Contact information
Practice address
15145A LAKESHORE DRIVE, LAKE COUNTY MENTAL HEALTH, CLEARLAKE, CA 95422
(707) 994-7090
(707) 994-7096
Mailing address
10899 NORTH SLOPE DRIVE, KELSEYVILLE, CA 95451
(707) 994-7090
(707) 994-7096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A3773397
CA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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