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1144636390
ROY LAKES
FULLERTON, CA
NPI
1144636390
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-07-09
Last Update Date
2014-07-09
Business Address
-- ROY LAKES
218 E COMMONWEALTH AVE
FULLERTON, CA 92832-1911
Phone number: 714-992-4770
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Mailing Address
-- ROY LAKES
218 E COMMONWEALTH AVE
FULLERTON, CA 92832-1911
Phone number: 714-992-4770
Copy
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