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>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1982176756

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
41945 BIG BEAR BLVD STE 221, 222, 223 BIG BEAR LAKE, CA 92315 US
Tel: 909-866-5070  Fax: 909-878-3228

Contact information for business:
PO BOX 1927  BIG BEAR LAKE, CA 92315-1927 US
Tel: 909-866-5070  Fax: 909-878-3228

Registration Information:
NPI: 1982176756
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers

Legacy codes, insurance codes and state license numbers:



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