Individual
CHANTE STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 E FESLER ST, SANTA MARIA, CA 93454-4404
(805) 922-6597
Mailing address
245 INGER DR STE 103B, SANTA MARIA, CA 93454-8669
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/27/2016
Last updated
10/18/2018
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