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Individual

AMY HEUANSAVATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RADT

Contact information

Practice address
520 N LA BREA AVE, INGLEWOOD, CA 90302-3049
(323) 294-4932
Mailing address
2900 CRENSHAW BLVD, LOS ANGELES, CA 90016-4265
(323) 293-6284

Taxonomy

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

Other

Enumeration date
08/15/2018
Last updated
08/15/2018
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