| Doctor Name: | MS. TINA BETH MCINTIRE |
| NPI Number: | 1184769648 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | LADAC LR 160 112 |
| Business Practice Address: | 9905 Prospect Ave Santee, CA - 920714318 |
| Business Phone Number: | 6193339003 |
| Business Fax Number: | |
| Mailing Address: | Po Box 862, PINE VALLEY |
| State: | CA |
| Postal Code: | 919620862 |
| Phone Number: | 6193227776 |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2007 |
| NPI Last Update Date: | 07/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LADAC LR 160 112 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |