Individual
CARMEN MARIE PUEBLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
349 W 11TH ST, SAN BERNARDINO, CA 92410-3513
(909) 506-1247
Mailing address
1100 N D ST, SAN BERNARDINO, CA 92410-3524
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1507820523
CA
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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