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1093985384
STANISLAV MODIN
LOS ANGELES, CA
NPI
1093985384
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-03-03
Last Update Date
2008-03-03
Business Address
Mr. STANISLAV MODIN
1318 N ORANGE DR APT 303
LOS ANGELES, CA 90028-7571
Phone number: 323-962-4493
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Mailing Address
Mr. STANISLAV MODIN
1318 N ORANGE DR APT 303
LOS ANGELES, CA 90028-7571
Phone number: 323-962-4493
Copy
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