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1689981128
TERRELL KORNEGAY
LONG BEACH, CA
NPI
1689981128
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-09-03
Last Update Date
2010-09-03
Business Address
-- TERRELL KORNEGAY
337 ATLANTIC AVE
LONG BEACH, CA 90802-2554
Phone number: 310-997-6397
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Mailing Address
-- TERRELL KORNEGAY
337 ATLANTIC AVE
LONG BEACH, CA 90802-2554
Phone number: 310-997-6397
Copy
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