Individual
MS. JENISSA DAWN CHINTELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4337 BLACKWOOD ST., NEWUBRY PARK, CA 91320
(909) 709-2459
Mailing address
165 HICKORY RIDGE WAY, SUMMERVILLE, SC 29483-9759
(909) 709-2459
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
1488
SC
Other
Enumeration date
09/11/2012
Last updated
12/11/2017
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