CHANNING GREDVIG

SAN DIEGO, CA
NPI1003113622
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: CA  64651)
Enumeration Date2011-02-16
Last Update Date2021-11-29
Business Address
CHANNING GREDVIG LCSW
3420 KENYON ST
SAN DIEGO, CA 92110-5001
Phone number: 619-221-6550
Mailing Address
CHANNING GREDVIG LCSW
3420 KENYON ST
SAN DIEGO, CA 92110-5001
Phone number: 619-221-6550
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