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1114706298
SALLY SHIVELY
POMONA, CA
NPI
1114706298
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1497220223)
Enumeration Date
2023-09-27
Last Update Date
2023-09-27
Business Address
SALLY SHIVELY
831 E ARROWHIGHYWAY
POMONA, CA 91767
Phone number: 909-634-2950
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Mailing Address
SALLY SHIVELY
1350 SAN BERNARDINO RD SPC 68
UPLAND, CA 91786-4939
Phone number: 626-274-3239
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