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General NPI Number Information
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NPI Number | 1457818437
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Entity Type | Organization
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Legal Business Name | GIRLS GOSSIP AND WOMEN NETWORK LLC
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 04/06/2019
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Provider Practice Location Address
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Address Line | 9791 ARROW RTE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3602
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Country | US
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Telephone | 909-767-3593
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Fax |
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Provider Business Mailing Address
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Address Line | 12223 HIGHLAND AVE # 106-580
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2574
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Country | US
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Telephone | 909-767-3593
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | SANIYYAH SHALEECE MAYO
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Credential | LMFT
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Telephone | 909-767-3593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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