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DESIRAY BUNTAIN

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1225201593

Individual Registrant:
 DESIRAY  BUNTAIN 
Gender: F
Sole Proprietor

Location and contact information for practice:
5200 SAN GABRIEL PL  PICO RIVERA, CA 90660-2497 US
Tel: 562-222-1331  Fax: --

Contact information for business:
5200 SAN GABRIEL PL  PICO RIVERA, CA 90660-2497 US
Tel: --  Fax: --

Registration Information:
NPI: 1225201593
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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