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1790087435
BERVICK DECULUS
LOS ANGELES, CA
NPI
1790087435
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-12-01
Last Update Date
2010-12-01
Business Address
-- BERVICK DECULUS
3210 W JEFFERSON BLVD
LOS ANGELES, CA 90018-3230
Phone number: 323-731-4981
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Mailing Address
-- BERVICK DECULUS
3210 W JEFFERSON BLVD
LOS ANGELES, CA 90018-3230
Phone number: 323-731-4981
Copy
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