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1104432871
KYLE VINCENT CONNEALLY
SAN PEDRO, CA
NPI
1104432871
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-09-18
Last Update Date
2020-09-18
Business Address
KYLE VINCENT CONNEALLY
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 310-514-4940
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Mailing Address
KYLE VINCENT CONNEALLY
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 310-514-4940
Copy
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