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1992463541
STAICY MARAVILLAS
SAN PEDRO, CA
NPI
1992463541
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-12-01
Last Update Date
2021-12-01
Business Address
STAICY MARAVILLAS
235 W 9TH ST
SAN PEDRO, CA 90731-3711
Phone number: 310-521-9209
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Mailing Address
STAICY MARAVILLAS
235 W 9TH ST
SAN PEDRO, CA 90731-3711
Phone number: 310-521-9209
Copy
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