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1356467716
RICHARD TRAVIESIO
LOS ANGELES, CA
NPI
1356467716
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-03-21
Last Update Date
2007-07-08
Business Address
-- RICHARD TRAVIESIO
5715 S BROADWAY
LOS ANGELES, CA 90037-4131
Phone number: 323-948-0444
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Mailing Address
-- RICHARD TRAVIESIO
5715 S BROADWAY
LOS ANGELES, CA 90037-4131
Phone number: 323-948-0444
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