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General NPI Number Information
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NPI Number | 1275821241
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Entity Type | Individual
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Provider Name | VINSON O'NEAL ANTHONY SR. COUNSELOR
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Gender | Male
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 8455 S VAN NESS AVE
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City | INGLEWOOD
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State | CA
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Zip | 90305-1519
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Country | US
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Telephone | 323-565-2043
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Fax |
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Provider Business Mailing Address
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Address Line | 8455 S VAN NESS AVE
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City | INGLEWOOD
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State | CA
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Zip | 90305-1519
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Country | US
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Telephone | 323-565-2043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A1103011744
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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