JUSTIN WYATT CIASULLO

UPLAND, CA
NPI1346068624
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  19137)
Enumeration Date2024-09-26
Last Update Date2024-10-24
Business Address
JUSTIN WYATT CIASULLO
239 W 9TH ST
UPLAND, CA 91786-5979
Phone number: 909-981-6121
Mailing Address
JUSTIN WYATT CIASULLO
28561 KALMIA AVE
MORENO VALLEY, CA 92555-6521
Phone number: 951-743-6921
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