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1164815775
TYIESHA JACQUETT
SPRING VALLEY, CA
NPI
1164815775
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-03-07
Last Update Date
2015-03-07
Business Address
-- TYIESHA JACQUETT
2315 BAR BIT RD
SPRING VALLEY, CA 91978-1901
Phone number: 619-337-3830
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Mailing Address
-- TYIESHA JACQUETT
2315 BAR BIT RD
SPRING VALLEY, CA 91978-1901
Phone number: 619-337-3830
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