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1144848581
AVISSA ILKHAN
RESEDA, CA
NPI
1144848581
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1395550620)
Enumeration Date
2020-07-13
Last Update Date
2020-07-13
Business Address
AVISSA ILKHAN
7101 BAIRD AVE
RESEDA, CA 91335-4150
Phone number: 818-342-5897
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Mailing Address
AVISSA ILKHAN
10201 MASON AVE UNIT 63
CHATSWORTH, CA 91311-3310
Phone number: 310-994-8800
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