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1740781012
CODY SHORE
LOS ANGELES, CA
NPI
1740781012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-02-22
Last Update Date
2018-02-22
Business Address
CODY SHORE
909 W TEMPLE ST
LOS ANGELES, CA 90012-3981
Phone number: 872-226-7447
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Mailing Address
CODY SHORE
909 W TEMPLE ST
LOS ANGELES, CA 90012-3981
Phone number:
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