LARISSA EMILY KIBORT

DANA POINT, CA
NPI1053042242
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  Ci35830622)
Enumeration Date2022-06-20
Last Update Date2022-06-20
Business Address
LARISSA EMILY KIBORT CADC
34185 VIOLET LANTERN ST UNIT 103
DANA POINT, CA 92629-2508
Phone number: 949-356-7952
Mailing Address
LARISSA EMILY KIBORT CADC
24341 CONEJO APT 4
LAGUNA HILLS, CA 92656-3144
Phone number: 708-446-1162