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1194066449
GENESIS MALLARI LORICA
LONG BEACH, CA
NPI
1194066449
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-03-12
Last Update Date
2013-03-12
Business Address
Mr. GENESIS MALLARI LORICA
2703 E 7TH ST
LONG BEACH, CA 90804-4708
Phone number: 562-433-0454
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Mailing Address
Mr. GENESIS MALLARI LORICA
2703 E 7TH ST
LONG BEACH, CA 90804-4708
Phone number: 562-433-0454
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