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1902448038
STEPHEN WILSON
LOS ANGELES, CA
NPI
1902448038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA r1367131019)
Enumeration Date
2019-10-10
Last Update Date
2019-10-10
Business Address
STEPHEN WILSON
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
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Mailing Address
STEPHEN WILSON
5318 CRENSHAW BLVD
LOS ANGELES, CA 90043-1810
Phone number: 323-293-6291
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