Provider Demographics
NPI:1578386751
Name:DROUILLARD, AYMEE LINETTE
Entity type:Individual
Prefix:
First Name:AYMEE
Middle Name:LINETTE
Last Name:DROUILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3565 W BARSTOW AVE APT 123
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6680
Mailing Address - Country:US
Mailing Address - Phone:559-601-9589
Mailing Address - Fax:
Practice Address - Street 1:1204 W SHAW AVE # 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3706
Practice Address - Country:US
Practice Address - Phone:559-681-1947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1587571124101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)