Individual
BRIANNE MARIE KORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4750 PALM AVE, RIVERSIDE, CA 92501-4012
(951) 686-0021
Mailing address
2743 ORANGE ST, RIVERSIDE, CA 92501-2503
(951) 515-7680
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C035110715
CA
Other
Enumeration date
02/06/2017
Last updated
10/01/2020
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