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1255934022
KIERAN ROOT
FULLERTON, CA
NPI
1255934022
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1408231020)
Enumeration Date
2020-11-16
Last Update Date
2020-11-16
Business Address
KIERAN ROOT R1408231020
771 W ORANGETHORPE AVE
FULLERTON, CA 92832-2806
Phone number: 714-879-0929
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Mailing Address
KIERAN ROOT R1408231020
771 W ORANGETHORPE AVE
FULLERTON, CA 92832-2806
Phone number: 714-879-0929
Copy
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