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1144893611
DEREK ANTHONY TYWONIUK
WEST HOLLYWOOD, CA
NPI
1144893611
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-07-21
Last Update Date
2021-07-22
Business Address
DEREK ANTHONY TYWONIUK RADT
8739 SANTA MONICA BLVD
WEST HOLLYWOOD, CA 90069-4507
Phone number: 310-623-1477
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Mailing Address
DEREK ANTHONY TYWONIUK RADT
8739 SANTA MONICA BLVD
WEST HOLLYWOOD, CA 90069-4507
Phone number: 310-623-1477
Copy
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