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1073746681
GABRIELLE J. FORMAN
LOS ANGELES, CA
NPI
1073746681
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS 24101)
Enumeration Date
2009-08-30
Last Update Date
2009-08-30
Business Address
-- GABRIELLE J. FORMAN L.C.S.W.
2904 ROWENA AVE
LOS ANGELES, CA 90039-2042
Phone number: 310-625-2102
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Mailing Address
-- GABRIELLE J. FORMAN L.C.S.W.
3507 MADERA AVE
LOS ANGELES, CA 90039-1929
Phone number: 310-625-2102
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