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1073369518
THADDEUS CORNELIUS CARROLL
LOS ANGELES, CA
NPI
1073369518
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: RADT-R1509870623)
Enumeration Date
2024-04-25
Last Update Date
2024-04-25
Business Address
THADDEUS CORNELIUS CARROLL
1045 E 20TH ST
LOS ANGELES, CA 90011-1107
Phone number: 213-205-8221
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Mailing Address
THADDEUS CORNELIUS CARROLL
1045 E 20TH ST
LOS ANGELES, CA 90011-1107
Phone number: 213-205-8221
Copy
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