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TAYA BERRY MBA

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

Registrant NPI Number: 1740820083

Individual Registrant:
 TAYA  BERRY MBA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
11776 MARIPOSA RD  HESPERIA, CA 92345-1622 US
Tel: 760-956-2462  Fax: --

Contact information for business:
11776 MARIPOSA RD # 103  HESPERIA, CA 92345-1622 US
Tel: 760-956-2462  Fax: --

Registration Information:
NPI: 1740820083
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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