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1093987166
JACK DUANE EDMONDSON
POWAY, CA
NPI
1093987166
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 1903)
Enumeration Date
2008-03-29
Last Update Date
2008-03-29
Business Address
-- JACK DUANE EDMONDSON LCSW
14207 KENDRA WAY
POWAY, CA 92064-3330
Phone number: 858-748-7093
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Mailing Address
-- JACK DUANE EDMONDSON LCSW
14207 KENDRA WAY
POWAY, CA 92064-3330
Phone number: 858-748-7093
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