MARCO AUGUSTO BANUELOS

LOS ANGELES, CA
NPI1265942759
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-10-10
Last Update Date2017-10-10
Business Address
MARCO AUGUSTO BANUELOS
2010 LINCOLN PARK AVE
LOS ANGELES, CA 90031-3119
Phone number: 323-222-1440
Mailing Address
MARCO AUGUSTO BANUELOS
2010 LINCOLN PARK AVE
LOS ANGELES, CA 90031-3119
Phone number:
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