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1942351887
TANYA KRISTINE BAESA-SEVILLANO
MODESTO, CA
NPI
1942351887
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-01-16
Last Update Date
2007-07-08
Business Address
-- TANYA KRISTINE BAESA-SEVILLANO
103 MODESTO AVE
MODESTO, CA 95354-0414
Phone number: 209-527-4597
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Mailing Address
-- TANYA KRISTINE BAESA-SEVILLANO
103 MODESTO AVE
MODESTO, CA 95354-0414
Phone number: 209-527-4597
Copy
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