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1083454425
ISAAC TY LITTLE
GARDEN GROVE, CA
NPI
1083454425
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1545080124)
Enumeration Date
2024-05-31
Last Update Date
2024-05-31
Business Address
ISAAC TY LITTLE
12781 JOSEPHINE ST
GARDEN GROVE, CA 92841-4622
Phone number: 657-251-0503
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Mailing Address
ISAAC TY LITTLE
2885 FAIRVIEW RD APT E201
COSTA MESA, CA 92626-4124
Phone number: 360-301-0367
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