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1720338619
BENJAMIN SUPKOFF
LOS ANGELES, CA
NPI
1720338619
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2012-09-18
Last Update Date
2012-09-18
Business Address
Mr. BENJAMIN SUPKOFF
765 WEYBURN TER #102
LOS ANGELES, CA 90024-2843
Phone number: 916-743-1606
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Mailing Address
Mr. BENJAMIN SUPKOFF
765 WEYBURN TER #102
LOS ANGELES, CA 90024-2843
Phone number: 916-743-1606
Copy
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