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1164031332
CORRIE LEANNE GRADNEY
TARZANA, CA
NPI
1164031332
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA r1398870720)
Enumeration Date
2020-07-23
Last Update Date
2020-07-23
Business Address
CORRIE LEANNE GRADNEY RADT
18646 OXNARD ST
TARZANA, CA 91356-1486
Phone number: 818-996-1051
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Mailing Address
CORRIE LEANNE GRADNEY RADT
18646 OXNARD ST
TARZANA, CA 91356-1486
Phone number: 818-996-1051
Copy
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