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1992905483
WAYNE ANTHONY TOLLIVER
LOS ANGELES, CA
NPI
1992905483
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-07-23
Last Update Date
2007-07-23
Business Address
Mr. WAYNE ANTHONY TOLLIVER
2931 W FLORENCE AVE
LOS ANGELES, CA 90043-5110
Phone number: 323-750-8040
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Mailing Address
Mr. WAYNE ANTHONY TOLLIVER
2931 W FLORENCE AVE
LOS ANGELES, CA 90043-5110
Phone number: 323-750-8040
Copy
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