Individual
CHARITY INCLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 E THELBORN ST, WEST COVINA, CA 91791-1442
(626) 915-3844
Mailing address
1825 E THELBORN ST, WEST COVINA, CA 91791-1442
(626) 915-3844
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/10/2015
Last updated
01/19/2017
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