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1174038756
MARK GLENN WILLOUGHBY
EL MONTE, CA
NPI
1174038756
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2017-12-05
Last Update Date
2017-12-05
Business Address
MARK GLENN WILLOUGHBY
3430 COGSWELL RD
EL MONTE, CA 91732-2785
Phone number: 626-453-3400
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Mailing Address
MARK GLENN WILLOUGHBY
3430 COGSWELL RD
EL MONTE, CA 91732-2785
Phone number:
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