CHARLES DWAYNE COOPER

CANOGA PARK, CA
NPI1255590956
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2008-06-06
Last Update Date2008-06-06
Business Address
-- CHARLES DWAYNE COOPER
22030 SHERMAN WAY
CANOGA PARK, CA 91303-1855
Phone number: 818-340-0230
Mailing Address
-- CHARLES DWAYNE COOPER
676 S CENTRAL AVE
LOS ANGELES, CA 90021-1039
Phone number: