ELHAM ELLIE MANDAVI BERENJI

GEORGETOWN, TX
NPI1912501941
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX  15161)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: TX  82942)
Enumeration Date2020-11-30
Last Update Date2020-11-30
Business Address
ELHAM ELLIE MANDAVI BERENJI
121 BRUNNEN WAY
GEORGETOWN, TX 78626-2620
Phone number: 210-717-6155
Mailing Address
ELHAM ELLIE MANDAVI BERENJI
121 BRUNNEN WAY
GEORGETOWN, TX 78626-2620
Phone number: 210-717-6155