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1205560703
MICHAEL ANTHONY BANUELOS
POMONA, CA
NPI
1205560703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: CA ASW123584)
Enumeration Date
2022-07-12
Last Update Date
2024-08-05
Business Address
MR. MICHAEL ANTHONY BANUELOS MSW
1900 ROYALTY DR STE 180
POMONA, CA 91767-3046
Phone number: 909-766-7340
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Mailing Address
MR. MICHAEL ANTHONY BANUELOS MSW
9916 CENTRAL AVE
MONTCLAIR, CA 91763-3201
Phone number: 909-450-2502
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