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1942974761
ANTHONY JACOB ITKIN
TARZANA, CA
NPI
1942974761
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-08-04
Last Update Date
2021-09-30
Business Address
ANTHONY JACOB ITKIN
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 888-777-8565
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Mailing Address
ANTHONY JACOB ITKIN
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 323-533-3229
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