Individual
ALEXANDRA KETTNER VICTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8739 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4507
(310) 623-1477
(310) 854-0134
Mailing address
8739 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4507
(310) 623-1477
(310) 854-0134
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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