DEREK MARTIN GAXIOLA

LOS ANGELES, CA
NPI1801691332
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2025-02-18
Last Update Date2025-02-18
Business Address
DEREK MARTIN GAXIOLA
2032 MARENGO ST
LOS ANGELES, CA 90033-1319
Phone number: 323-541-3526
Mailing Address
DEREK MARTIN GAXIOLA
2032 MARENGO ST
LOS ANGELES, CA 90033-1319
Phone number: 323-541-3526