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1992992564
STEPHANIE CHISM
LOS ANGELES, CA
NPI
1992992564
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-09-27
Last Update Date
2007-09-27
Business Address
-- STEPHANIE CHISM
8346 BEVERLY BLVD
LOS ANGELES, CA 90048-2632
Phone number: 323-659-1677
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Mailing Address
-- STEPHANIE CHISM
26460 SUMMIT CIR
SANTA CLARITA, CA 91350-2991
Phone number:
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