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1750835898
IETI LEAEA
LOS ANGELES, CA
NPI
1750835898
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA A09310315)
Enumeration Date
2016-08-05
Last Update Date
2016-08-05
Business Address
-- IETI LEAEA
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
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Mailing Address
-- IETI LEAEA
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
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