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1063926103
LISA ANTIONETTE BLAZIO
LONG BEACH, CA
NPI
1063926103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-11-28
Last Update Date
2017-11-28
Business Address
LISA ANTIONETTE BLAZIO
3125 E 7TH ST
LONG BEACH, CA 90804-4932
Phone number: 562-987-5722
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Mailing Address
LISA ANTIONETTE BLAZIO
1041 REDONDO AVE
LONG BEACH, CA 90804-3928
Phone number: 562-987-5722
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