Individual
JEANNIE LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14687 ROUND LEAF RD, MORENO VALLEY, CA 92555-4742
(951) 488-1929
Mailing address
14687 ROUND LEAF RD, MORENO VALLEY, CA 92555-4742
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PCCI2179
CA
101YS0200X
School Counselor
—
CA
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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