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1982168647
CANDACE MAE VAILLETTE
LOS ANGELES, CA
NPI
1982168647
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-01-28
Last Update Date
2022-11-07
Business Address
CANDACE MAE VAILLETTE
515 E 6TH ST
LOS ANGELES, CA 90021-1009
Phone number: 213-529-0963
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Mailing Address
CANDACE MAE VAILLETTE
21163 CONKLIN BLVD
CALIFORNIA CITY, CA 93505-2273
Phone number: 909-242-1940
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