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1770766594
VANESSA ANNWANETT KANISTANAUX
PASADENA, CA
NPI
1770766594
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-12-14
Last Update Date
2007-12-14
Business Address
-- VANESSA ANNWANETT KANISTANAUX
1460 N LAKE AVE SUITE 107
PASADENA, CA 91104-2300
Phone number: 626-398-3796
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Mailing Address
-- VANESSA ANNWANETT KANISTANAUX
1045 N GARFIELD AVE
PASADENA, CA 91104-3533
Phone number: 626-533-1804
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