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1205959244
EDDIE D COLBERT
LOS ANGELES, CA
NPI
1205959244
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA CAS #4866)
Enumeration Date
2007-04-06
Last Update Date
2007-07-08
Business Address
-- EDDIE D COLBERT
11905 S CENTRAL AVE SUITE 205
LOS ANGELES, CA 90059-2836
Phone number: 323-249-9026
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Mailing Address
-- EDDIE D COLBERT
5414 KNOXVILLE AVE
LAKEWOOD, CA 90713-1736
Phone number: 310-850-0640
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