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1659571735
ELIJAH FAGGINS
LOS ANGELES, CA
NPI
1659571735
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-07-18
Last Update Date
2007-07-18
Business Address
-- ELIJAH FAGGINS
5310 S HOOVER ST
LOS ANGELES, CA 90037-3734
Phone number: 310-916-3532
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Mailing Address
-- ELIJAH FAGGINS
5310 S HOOVER ST
LOS ANGELES, CA 90037-3734
Phone number:
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