| Reignite Brilliance, Llc | |
|
5252 Balboa Ave Ste 803 San Diego CA 92117-6920 | |
| (858) 882-7872 | |
| Not Available |
| Full Name | Reignite Brilliance, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 5252 Balboa Ave Ste 803, San Diego, California |
| Authorized Official Name and Position | Jeannette Gilmore (OWNER) |
| Authorized Official Contact | 8588827872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reignite Brilliance, Llc Po Box 17369 San Diego CA 92177-7369 Ph: (858) 882-7872 | Reignite Brilliance, Llc 5252 Balboa Ave Ste 803 San Diego CA 92117-6920 Ph: (858) 882-7872 |
| NPI Number | 1306692389 |
|---|---|
| Provider Enumeration Date | 04/29/2024 |
| Last Update Date | 04/29/2024 |
| Certification Date | 04/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306692389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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