Individual
MR. ALLAN EDWARD HARRAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AOD
Contact information
Practice address
614 W MANCHESTER BLVD STE 104, INGLEWOOD, CA 90301-1683
(310) 412-0879
Mailing address
2051 W 22ND ST #207, LOS ANGELES, CA 90018
(323) 302-2765
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C30111214
CA
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
743045262
TAX ID
CA
Enumeration date
06/08/2007
Last updated
04/09/2019
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