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1760216964
SAMANTHA ROSE ILAN
GARDEN GROVE, CA
NPI
1760216964
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-08-29
Last Update Date
2024-08-29
Business Address
SAMANTHA ROSE ILAN
13222 CHAPMAN AVE
GARDEN GROVE, CA 92840-4414
Phone number: 855-588-1422
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Mailing Address
SAMANTHA ROSE ILAN
13222 CHAPMAN AVE
GARDEN GROVE, CA 92840-4414
Phone number: 855-588-1422
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