NPI | 1477004802 |
---|---|
Former Name | JOHN ACEVES FLORES |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1-F1109112058) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2016-10-20 |