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1922860436
QIANA DESTINY TRINITY BURKE
GRASS VALLEY, CA
NPI
1922860436
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-01-29
Last Update Date
2024-01-29
Business Address
QIANA DESTINY TRINITY BURKE RADT
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-460-4082
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Mailing Address
QIANA DESTINY TRINITY BURKE RADT
185 E MAIN ST UNIT 3066
GRASS VALLEY, CA 95945-9223
Phone number: 530-615-8154
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