Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003295841 |
---|---|
Provider Name | Melissa Dubriel |
First Address | West Covina, CA 91791-1442 |
Second Address | West Covina, CA 91791-1442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2015 |
Last Update Date | 27/05/2015 |