EMERSON GROOM

SANTA ANA, CA
NPI1619493210
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1242690217)
Enumeration Date2017-08-16
Last Update Date2017-08-16
Business Address
EMERSON GROOM RADT1
2101 E 1ST ST
SANTA ANA, CA 92705-4007
Phone number: 714-581-9181
Mailing Address
EMERSON GROOM RADT1
3050 S BRISTOL ST 8Q
SANTA ANA, CA 92704-6727
Phone number: 714-583-1565
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