KOSE IKENASIO

SAN BERNARDINO, CA
NPI1417352501
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  73873)
Enumeration Date2014-10-31
Last Update Date2017-03-17
Business Address
-- KOSE IKENASIO ACSW, MSW
900 E GILBERT ST BLDG 5
SAN BERNARDINO, CA 92415-0911
Phone number: 909-387-7686
Mailing Address
-- KOSE IKENASIO ACSW, MSW
PO BOX 3171
LAKEWOOD, CA 90711-3171
Phone number: