Individual
VICTORIA E BERRUECOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
2197 S 4TH AVE STE 202, YUMA, AZ 85364-6473
(928) 581-8624
Mailing address
192 N 5TH AVE, YUMA, AZ 85364-1320
(559) 509-4090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1457610222
CA
101YM0800X
Mental Health Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/10/2022
Last updated
01/10/2023
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