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1124871181
CHARLES NICKELL
SAN FERNANDO, CA
NPI
1124871181
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA Ci42120324)
Enumeration Date
2024-04-09
Last Update Date
2024-04-09
Business Address
Mr. CHARLES NICKELL
762 GRISWOLD AVE
SAN FERNANDO, CA 91340-2105
Phone number: 747-500-9405
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Mailing Address
Mr. CHARLES NICKELL
386 MERRILL AVE
GLENDALE, CA 91206-4108
Phone number:
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