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1205045119
LEO VORAPON SAGNANERT
GLENDALE, CA
NPI
1205045119
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-21
Last Update Date
2007-07-08
Business Address
Mr. LEO VORAPON SAGNANERT
4628 SAN FERNANDO RD
GLENDALE, CA 91204
Phone number: 818-240-8843
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Mailing Address
Mr. LEO VORAPON SAGNANERT
4628 SAN FERNANDO RD
GLENDALE, CA 91204-1822
Phone number: 818-240-8843
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