THEADORE GREEN

LOS ANGELES, CA
NPI1053854232
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R24571214)
Enumeration Date2016-11-21
Last Update Date2016-11-21
Business Address
-- THEADORE GREEN RADT-I
515 E 6TH ST
LOS ANGELES, CA 90021-1009
Phone number: 213-689-2179
Mailing Address
-- THEADORE GREEN RADT-I
515 E 6TH ST
LOS ANGELES, CA 90021-1009
Phone number: 213-689-2179
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