CODY SPENCER BLACK

SAN PEDRO, CA
NPI1174377055
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1557170424)
Enumeration Date2024-04-16
Last Update Date2024-04-16
Business Address
CODY SPENCER BLACK RADT
132 W 10TH ST
SAN PEDRO, CA 90731-3702
Phone number: 310-514-4940
Mailing Address
CODY SPENCER BLACK RADT
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 310-514-4940
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