Individual
ALISA DIANE ETCHELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Contact information
Practice address
1001 TOWER WAY STE 140, BAKERSFIELD, CA 93309-1586
(661) 634-9877
(661) 864-0198
Mailing address
1001 TOWER WAY STE 140, BAKERSFIELD, CA 93309-1586
(661) 634-9877
(661) 864-0198
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1543620124
CA
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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