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1861810244
GENEVRA DIANA GLENN
BANNING, CA
NPI
1861810244
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 11980613)
Enumeration Date
2014-04-02
Last Update Date
2014-04-02
Business Address
Mrs. GENEVRA DIANA GLENN
2781 W RAMSEY SUITE 1
BANNING, CA 92220
Phone number: 951-849-3896
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Mailing Address
Mrs. GENEVRA DIANA GLENN
2781 W RAMSEY
BANNING, CA 92220
Phone number: 951-849-3896
Copy
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