| 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 |