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1710240726
MIESHA RENEE GAMMAGE
MODESTO, CA
NPI
1710240726
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-06-25
Last Update Date
2012-06-25
Business Address
Ms. MIESHA RENEE GAMMAGE M.S. Counseling
103 MODESTO AVE
MODESTO, CA 95354-0414
Phone number: 209-527-4597
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Mailing Address
Ms. MIESHA RENEE GAMMAGE M.S. Counseling
PO BOX 5067
OAKLAND, CA 94605-0067
Phone number: 510-228-5487
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