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1386412997
ERIC TYRONE DOUGLAS
TARZANA, CA
NPI
1386412997
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2023-12-13
Last Update Date
2023-12-13
Business Address
ERIC TYRONE DOUGLAS
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
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Mailing Address
ERIC TYRONE DOUGLAS
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
Copy
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