TANISHA JORDAN BALOGUN

RIVERSIDE, CA
NPI1750895298
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-11-20
Last Update Date2017-11-20
Business Address
TANISHA JORDAN BALOGUN
17270 ROOSEVELT ST # 304
RIVERSIDE, CA 92508-9523
Phone number: 951-780-2541
Mailing Address
TANISHA JORDAN BALOGUN
17270 ROOSEVELT ST # 304
RIVERSIDE, CA 92508-9523
Phone number: 951-780-2541
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