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1598518672
VAUGHNDRELL LANCE WATKINS
SAN PEDRO, CA
NPI
1598518672
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1531901023)
Enumeration Date
2024-04-09
Last Update Date
2024-04-09
Business Address
VAUGHNDRELL LANCE WATKINS RADT
132 W 10TH ST
SAN PEDRO, CA 90731-3702
Phone number: 310-514-4940
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Mailing Address
VAUGHNDRELL LANCE WATKINS RADT
1003 S BEACON ST
SAN PEDRO, CA 90731-4324
Phone number: 310-514-4940
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