KEITH ASCENCIO

HUNTINGTON PARK, CA
NPI1568822062
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1193120215)
Enumeration Date2016-02-26
Last Update Date2016-02-26
Business Address
-- KEITH ASCENCIO
3472 FLOWER ST
HUNTINGTON PARK, CA 90255-6135
Phone number: 323-829-2046
Mailing Address
-- KEITH ASCENCIO
3472 FLOWER ST
HUNTINGTON PARK, CA 90255-6135
Phone number:
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