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1548947070
DEREK DAVIDSON
TARZANA, CA
NPI
1548947070
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-06-27
Last Update Date
2023-06-27
Business Address
DEREK DAVIDSON
18646 OXNARD ST
TARZANA, CA 91356-1486
Phone number: 818-996-1051
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Mailing Address
DEREK DAVIDSON
18646 OXNARD ST
TARZANA, CA 91356-1486
Phone number:
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