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1730650128
MAIRA GONZALEZ-VIELMA
SHELTON, WA
NPI
1730650128
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-12-10
Last Update Date
2018-12-10
Business Address
MAIRA GONZALEZ-VIELMA
627 W FRANKLIN ST
SHELTON, WA 98584-3504
Phone number: 360-763-5610
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Mailing Address
MAIRA GONZALEZ-VIELMA
606 BEAR ST
SHELTON, WA 98584-4204
Phone number: 707-267-3149
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