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1023574498
SARA ANDREA VIDES
TARZANA, CA
NPI
1023574498
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1336760219)
Enumeration Date
2019-02-11
Last Update Date
2019-02-11
Business Address
SARA ANDREA VIDES RADT
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
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Mailing Address
SARA ANDREA VIDES RADT
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
Copy
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