Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003143678 |
---|---|
Provider Name | Mr. Dmitry Drabkin |
First Address | Van Nuys, CA 91411-2613 |
Second Address | Van Nuys, CA 91411-2613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2009 |
Last Update Date | 03/11/2009 |