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Dasha Witch-hazel Mactavish
Peer Specialist in San Diego, California
NPI 1679225759

Dasha Witch-hazel Mactavish is a Peer Specialist based in San Diego, CA. Dasha Witch-hazel Mactavish practices in San Diego, CA. The NPI Number for Dasha Witch-hazel Mactavish is 1679225759 and holds a License No. (California).

The current practice location address for Dasha Witch-hazel Mactavish is 1660 Hotel Cir N Ste 314, San Diego, CA and can be reached out via phone at 619-961-2120.

Location: 1660 Hotel Cir N Ste 314, San Diego, CA, 92108-2803
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679225759
Provider Name
Dasha Witch-hazel Mactavish
Credential
Provider Entity Type
Individual
Gender
Female
Address
1660 Hotel Cir N Ste 314, San Diego, CA, 92108-2803
Phone Number
619-961-2120
Fax Number
Provider Enumeration Date
01/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1660 Hotel Cir N Ste 314
City
San Diego
State
California
Zip
92108-2803
Phone Number
619-961-2120
Fax Number
person
Provider Business Mailing Address Details
Address
1660 Hotel Cir N Ste 314
City
San Diego
State
California
Zip
92108-2803
Phone Number
619-961-2120
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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