Individual
ANTHONY BOTRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 W VICTORIA ST, GARDENA, CA 90248
(909) 620-2521
Mailing address
108 W VICTORIA ST, GARDENA, CA 90248-3523
(310) 715-2020
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT97019
CA
Other
Enumeration date
08/30/2012
Last updated
09/05/2018
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