JONATHAN IDDAMALGODA

WOODLAND HILLS, CA
NPI1609641794
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  96000115)
Enumeration Date2023-11-17
Last Update Date2023-11-17
Business Address
JONATHAN IDDAMALGODA
6022 VARIEL AVE
WOODLAND HILLS, CA 91367-3719
Phone number: 818-996-1051
Mailing Address
JONATHAN IDDAMALGODA
6022 VARIEL AVE
WOODLAND HILLS, CA 91367-3719
Phone number: 818-996-1051
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