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1902402647
TERRELL VANSCIVER
LOS ANGELES, CA
NPI
1902402647
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-12-08
Last Update Date
2020-12-08
Business Address
TERRELL VANSCIVER
5849 CROCKER ST
LOS ANGELES, CA 90003-1311
Phone number: 951-464-3038
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Mailing Address
TERRELL VANSCIVER
14810 HALLDALE AVE APT 11
GARDENA, CA 90247-2870
Phone number: 951-464-3038
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