Individual
MRS. REGINA LYNN KOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, CADC-II
Contact information
Practice address
11440 W BERNARDO CT STE 300, SAN DIEGO, CA 92127-1644
(858) 295-0594
Mailing address
11440 W BERNARDO CT STE 300, SAN DIEGO, CA 92127-1644
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
RA862911
CA
101YP2500X
Professional Counselor
Primary
2471
CA
Other
Enumeration date
11/06/2011
Last updated
07/10/2022
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