Individual
BRYANNA GRACIELA AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 N D ST, SAN BERNARDINO, CA 92410-3523
(909) 888-6956
Mailing address
1100 N D ST, SAN BERNARDINO, CA 92410-3524
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1505780523
CA
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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