IETI LEAEA

LOS ANGELES, CA
NPI1750835898
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  A09310315)
Enumeration Date2016-08-05
Last Update Date2016-08-05
Business Address
-- IETI LEAEA
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
Mailing Address
-- IETI LEAEA
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
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