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1881968048
TEQUILA TESHELLE ANGELO
SACRAMENTO, CA
NPI
1881968048
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-03-05
Last Update Date
2012-03-05
Business Address
-- TEQUILA TESHELLE ANGELO
4343 WILLIAMSBOURGH DR
SACRAMENTO, CA 95823-2006
Phone number: 916-395-3552
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Mailing Address
-- TEQUILA TESHELLE ANGELO
6390 LOCHINVAR WAY
SACRAMENTO, CA 95823-5670
Phone number: 916-271-3491
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