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1447597919
STANISLAV TROFIMOV
VAN NUYS, CA
NPI
1447597919
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-01-03
Last Update Date
2013-01-03
Business Address
-- STANISLAV TROFIMOV
15015 OXNARD ST
VAN NUYS, CA 91411-2613
Phone number: 818-787-4151
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Mailing Address
-- STANISLAV TROFIMOV
15015 OXNARD ST
VAN NUYS, CA 91411-2613
Phone number: 818-787-4151
Copy
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