IMHOTEP MUSTAQEEM

SAN DIEGO, CA
NPI1104220912
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-10-22
Last Update Date2014-10-22
Business Address
-- IMHOTEP MUSTAQEEM
3336 STEEL STREET
SAN DIEGO, CA 92113
Phone number: 619-822-7919
Mailing Address
-- IMHOTEP MUSTAQEEM
3336 STEEL STREET
SAN DIEGO, CA 92113
Phone number: 619-822-7919
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