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1770095879
LEONARD WALLACE LANE
LOS ANGELES, CA
NPI
1770095879
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 76583)
Enumeration Date
2017-10-30
Last Update Date
2017-10-30
Business Address
Mr. LEONARD WALLACE LANE MFT Intern
1926 BEVERLY BLVD
LOS ANGELES, CA 90057-2402
Phone number: 213-353-1140
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Mailing Address
Mr. LEONARD WALLACE LANE MFT Intern
1926 BEVERLY BLVD
LOS ANGELES, CA 90057-2402
Phone number: 213-353-1140
Copy
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