| NPI | 1144669276 |
|---|---|
| Other Name | TISHA ELIZABETH URSUA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Aii3191214) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2020-04-01 |