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1740664614
CLINT JOHNSON
COSTA MESA, CA
NPI
1740664614
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA I8149079)
Enumeration Date
2015-07-10
Last Update Date
2015-07-10
Business Address
-- CLINT JOHNSON
3151 AIRWAY AVE D-1
COSTA MESA, CA 92626-4607
Phone number: 714-957-8229
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Mailing Address
-- CLINT JOHNSON
3151 AIRWAY AVE D-1
COSTA MESA, CA 92626-4607
Phone number: 714-957-8229
Copy
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