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1912460536
ANDREY ANTONENKO
GARDEN GROVE, CA
NPI
1912460536
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 103610)
Enumeration Date
2019-04-10
Last Update Date
2019-04-10
Business Address
ANDREY ANTONENKO AMFT
7281 GARDEN GROVE BLVD STE H
GARDEN GROVE, CA 92841-4212
Phone number: 714-460-3770
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Mailing Address
ANDREY ANTONENKO AMFT
21 CALIFORNIA AVE APT 208
IRVINE, CA 92612-3051
Phone number: 714-460-3770
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