Individual
IAN YUAN-JIAN BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
11303 W WASHINGTON BLVD, #200, LOS ANGELES, CA 90066-6003
(310) 482-3267
Mailing address
11303 W WASHINGTON BLVD, #200, LOS ANGELES, CA 90066-6003
(310) 482-3267
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW75211
CA
Other
Enumeration date
08/12/2011
Last updated
07/30/2019
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