ANTAWNY JEFFERSON

TARZANA, CA
NPI1851958045
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1345480419)
Enumeration Date2019-05-22
Last Update Date2019-05-22
Business Address
ANTAWNY JEFFERSON RADT
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
Mailing Address
ANTAWNY JEFFERSON RADT
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
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