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1336562545
VIDETH OK
LONG BEACH, CA
NPI
1336562545
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-01-23
Last Update Date
2014-01-23
Business Address
-- VIDETH OK
1900 ATLANTIC AVE
LONG BEACH, CA 90806-5502
Phone number: 562-218-9530
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Mailing Address
-- VIDETH OK
1088 S LA BREA AVE
LOS ANGELES, CA 90019-6905
Phone number: 562-218-9530
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