LARRY EDWARD ELLIS

VENTURA, CA
NPI1205311339
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1290810218)
Enumeration Date2018-09-25
Last Update Date2018-09-25
Business Address
Mr. LARRY EDWARD ELLIS RADT
800 S VICTORIA AVE
VENTURA, CA 93009-0001
Phone number: 805-766-5620
Mailing Address
Mr. LARRY EDWARD ELLIS RADT
800 S VICTORIA AVE
VENTURA, CA 93009-0001
Phone number: 805-766-5620
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