DASHA WITCH-HAZEL MACTAVISH NPI 1679225759

NPI Information

Dasha Witch-hazel Mactavish is a peer specialist in San Diego, CA. The provider is 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. Dasha Witch-hazel Mactavish NPI is 1679225759. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1660 HOTEL CIR N STE 314
SAN DIEGO, CA
ZIP 92108-803
Phone: (619) 961-2120

The enumeration date for this NPI number is 1/20/2022 and was last updated on 1/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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