BLAINE LATHAM

LOS ANGELES, CA
NPI1578454120
Entity TypeIndividual
GenderN/A
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  R1582051024)
Enumeration Date2025-07-11
Last Update Date2025-07-11
Business Address
BLAINE LATHAM R1582051024
2330 BEVERLY BLVD
LOS ANGELES, CA 90057-2220
Phone number: 213-549-8320
Mailing Address
BLAINE LATHAM R1582051024
2330 BEVERLY BLVD
LOS ANGELES, CA 90057-2220
Phone number: 213-549-8320