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1316273196
INNA PHOENIX GORE
RESEDA, CA
NPI
1316273196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2009-10-28
Last Update Date
2009-10-28
Business Address
INNA PHOENIX GORE
19231 VICTORY BLVD 554
RESEDA, CA 91335-6308
Phone number: 818-776-1755
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Mailing Address
INNA PHOENIX GORE
18930 SHERMAN WAY 17
RESEDA, CA 91335-7738
Phone number: 323-633-8610
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