Individual
DOLORES MARY BENISON-GLOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1207 E FRUIT ST, SANTA ANA, CA 92701-4296
(714) 953-9373
(714) 418-4634
Mailing address
1207 E FRUIT ST, SANTA ANA, CA 92701-4296
(714) 953-9373
(714) 418-4634
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
VN247827
CA
Other
Enumeration date
10/07/2020
Last updated
11/16/2020
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