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1205959277
JAQUELINE GALLEGOS
SANTA ROSA, CA
NPI
1205959277
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-06
Last Update Date
2007-07-08
Business Address
-- JAQUELINE GALLEGOS
1300 CODDINGTOWN CTR
SANTA ROSA, CA 95401-3537
Phone number: 707-565-7641
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Mailing Address
-- JAQUELINE GALLEGOS
513 CHIPMUNK CT
SANTA ROSA, CA 95401-5750
Phone number:
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