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Individual

ANNIE CELICE VANDERGRIFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
22030 SHERMAN WAY STE 115, CANOGA PARK, CA 91303-1889
(818) 340-0230
Mailing address
566 S SAN PEDRO ST # 447, LOS ANGELES, CA 90013-2102

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
01/05/2009
Last updated
01/05/2009
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