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1114497559
JAMES LINCOLN DETTMAN
SAN BERNARDINO, CA
NPI
1114497559
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1293770318)
Enumeration Date
2018-11-28
Last Update Date
2018-11-28
Business Address
JAMES LINCOLN DETTMAN
1100 N D ST
SAN BERNARDINO, CA 92410-3524
Phone number: 909-884-0840
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Mailing Address
JAMES LINCOLN DETTMAN
1100 N D ST
SAN BERNARDINO, CA 92410-3524
Phone number: 909-884-0840
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