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1841705530
MELISSA LENAE WATERS
SAN RAFAEL, CA
NPI
1841705530
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-12-05
Last Update Date
2017-12-05
Business Address
MELISSA LENAE WATERS
1477 LINCOLN AVE
SAN RAFAEL, CA 94901-2028
Phone number: 415-459-2395
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Mailing Address
MELISSA LENAE WATERS
1477 LINCOLN AVE
SAN RAFAEL, CA 94901-2028
Phone number:
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