| Second Chance Miniseries Welklness Center | |
|
289 N 19th Ave Apt 52 Lemoore CA 93245-2573 | |
| (805) 800-8209 | |
| Not Available |
| Full Name | Second Chance Miniseries Welklness Center |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 289 N 19th Ave Apt 52, Lemoore, California |
| Authorized Official Name and Position | Corey Wayne Boren (DR) |
| Authorized Official Contact | 9168934528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Miniseries Welklness Center 289 N 19th Ave Apt 52 Lemoore CA 93245-2573 Ph: (805) 800-8209 | Second Chance Miniseries Welklness Center 289 N 19th Ave Apt 52 Lemoore CA 93245-2573 Ph: (805) 800-8209 |
| NPI Number | 1588391734 |
|---|---|
| Provider Enumeration Date | 08/06/2022 |
| Last Update Date | 08/06/2022 |
| Certification Date | 08/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588391734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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