Individual
MONIQUE CHATRISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC INTERN
Contact information
Practice address
24174 WABERN DRIVE, CRESTLINE, CA 92325
(949) 940-6108
Mailing address
PO BOX 947, TWIN PEAKS, CA 92391-0947
(949) 940-6108
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2802
CA
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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