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Individual

MRS. AISSA LEA GARIN X

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
441 S HAM LN STE A, LODI, CA 95242-3525
(209) 224-8940
Mailing address
2418 CHRISTINA AVE, STOCKTON, CA 95204-1506
(209) 969-6546

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CA
106H00000X
Marriage & Family Therapist
Primary
110482
CA

Other

Enumeration date
12/17/2018
Last updated
04/04/2019
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