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1619493210
EMERSON GROOM
SANTA ANA, CA
NPI
1619493210
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1242690217)
Enumeration Date
2017-08-16
Last Update Date
2017-08-16
Business Address
EMERSON GROOM RADT1
2101 E 1ST ST
SANTA ANA, CA 92705-4007
Phone number: 714-581-9181
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Mailing Address
EMERSON GROOM RADT1
3050 S BRISTOL ST 8Q
SANTA ANA, CA 92704-6727
Phone number: 714-583-1565
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