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1174725261
MICHELLE M BRANTLEY
POMONA, CA
NPI
1174725261
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 085742)
Enumeration Date
2007-06-01
Last Update Date
2007-07-08
Business Address
Miss MICHELLE M BRANTLEY
558 N TOWNE AVE
POMONA, CA 91767-4826
Phone number: 909-622-2273
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Mailing Address
Miss MICHELLE M BRANTLEY
14412 HOMEWARD ST
LA PUENTE, CA 91744-2440
Phone number: 626-918-3139
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