Individual
ALISON DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1704 W MANCHESTER AVE STE 103, LOS ANGELES, CA 90047-3056
(323) 702-4520
Mailing address
1704 W MANCHESTER AVE STE 103, LOS ANGELES, CA 90047-3056
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5648
CAS NUMBER
CA
Enumeration date
06/06/2007
Last updated
07/08/2007
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