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Mr. Maxwell Jackson Antor
Mental Health Counselor in Richmond, California
NPI 1922292218

Maxwell Jackson Antor is a Mental Health Counselor based in Oakland, CA and is specialized in Mental Health. Maxwell Jackson Antor practices in Richmond, CA. The NPI Number for Maxwell Jackson Antor is 1922292218 and holds a License No. (California).

The current practice location address for Maxwell Jackson Antor is 4175 Lakeside Dr, Richmond, CA and can be reached out via phone at 510-262-6551.

Location: 4175 Lakeside Dr, Richmond, CA, 94609-2978
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922292218
Provider Name
Maxwell Jackson Antor
Credential
Provider Entity Type
Individual
Gender
Male
Address
4175 Lakeside Dr, Richmond, CA, 94609-2978
Phone Number
510-262-6551
Fax Number
Provider Enumeration Date
08/30/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4175 Lakeside Dr
City
Richmond
State
California
Zip
94806-5774
Phone Number
510-262-6551
Fax Number
person
Provider Business Mailing Address Details
Address
4175 Lakeside Dr
City
Richmond
State
California
Zip
94806-5774
Phone Number
510-262-6551
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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