Individual
GUADALUPE MACIAS MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
44199 MONROE ST, INDIO, CA 92201-3096
(760) 863-8424
(760) 770-2240
Mailing address
44199 MONROE ST, INDIO, CA 92201-3096
(760) 863-8424
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
12/07/2022
Last updated
10/19/2023
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