| NPI | 1245891191 |
|---|---|
| Former Name | PAMELA ANNE SISNEROS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Aii055240418) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |