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1609013911
SERGEI SHUPLETSOV
VAN NUYS, CA
NPI
1609013911
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2009-01-09
Last Update Date
2009-01-09
Business Address
Mr. SERGEI SHUPLETSOV
15015 OXNARD ST
VAN NUYS, CA 91411-2613
Phone number: 818-787-4151
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Mailing Address
Mr. SERGEI SHUPLETSOV
222 N LAKE ST
LOS ANGELES, CA 90026-4892
Phone number: 818-787-4151
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