NAUTICO INCORPORATED
Mental Health at Kettleman Ln, Lodi, CA

License number
California MFC30755
Category
Mental Health
Type
Mental Health
Owner
Name: MS. BEVERLY M BREAKEY L.M.F.T.
Title: CLINICAL COORDINATOR
Phone: (209) 334-2053
Address
Address
1420 W Kettleman Ln SUITE R, Lodi, CA 95242
National Provider ID: 1558666982
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NAUTICO, INC

1420 W Kettleman Ln STE R, Lodi, CA 95242

Registration:
Sep 22, 1970
State ID:
C0607762
Business type:
Articles of Incorporation
President:
Jerald Hackett (President)
Agent:
Charlotte Ann Yurkovic,Stockton, CA 95204 (Physical)
Categories:
Marriage & Family Counseling
Products:
Medical
Additional:
Individual Child & Family Counseling, Lic# LCS 22279

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