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1689128001
WAKANDA ROSE
SANTA ROSA, CA
NPI
1689128001
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-08-15
Last Update Date
2016-08-15
Business Address
-- WAKANDA ROSE MA
254 BREY RD
SANTA ROSA, CA 95409-5556
Phone number: 707-583-9304
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Mailing Address
-- WAKANDA ROSE MA
254 BREY RD
SANTA ROSA, CA 95409-5556
Phone number: 707-583-9304
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