DIVINA LIZA BAHAM

SANTA MONICA, CA
NPI1104345990
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-09-13
Last Update Date2022-07-21
Business Address
DIVINA LIZA BAHAM
909 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
Mailing Address
DIVINA LIZA BAHAM
909 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
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