JOHN FITZGERALD BAGNERISE

LOS ANGELES, CA
NPI1972897924
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2011-06-07
Last Update Date2011-06-07
Business Address
-- JOHN FITZGERALD BAGNERISE
5838 OVERHILL DR
LOS ANGELES, CA 90043-2725
Phone number: 323-295-0009
Mailing Address
-- JOHN FITZGERALD BAGNERISE
5838 OVERHILL DR
LOS ANGELES, CA 90043-2725
Phone number: 323-295-0009
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