Individual provider · Type 1 NPI

Mary Gurrola, CADTP

Addiction (Substance Use Disorder) Counselor · San Bernardino, CA

NPI number 1124168455 Active

Practice location

1094 S E St
San Bernardino, CA 92415-5230

Call (909) 388-1905 Map

Fax (909) 381-1062

Other practice locations

  • 850 E Foothill Blvd, Rialto, CA 92376-5230 · (909) 421-9406

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XG0407170935 (CA)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X6029 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1124168455

Mary Gurrola, CADTP's National Provider Identifier is 1124168455, issued on Feb 7, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Bernardino, CA. The record was last updated on Jan 5, 2023.