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1841064912
CHARLES ELLIS
SAN DIEGO, CA
NPI
1841064912
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1527390923)
Enumeration Date
2023-11-09
Last Update Date
2023-11-09
Business Address
CHARLES ELLIS
835 25TH ST
SAN DIEGO, CA 92102-2738
Phone number: 619-239-9691
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Mailing Address
CHARLES ELLIS
835 25TH ST
SAN DIEGO, CA 92102-2738
Phone number: 619-239-9691
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