NPI | 1316065279 |
---|---|
Former Name | JENNY MAGDALENO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 061321) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2019-02-13 |