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1124527015
GREGORY NEIL MOFFETT
VISTA, CA
NPI
1124527015
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 12297-R)
Enumeration Date
2018-02-06
Last Update Date
2018-02-06
Business Address
Mr. GREGORY NEIL MOFFETT
504 W VISTA WAY
VISTA, CA 92083-5704
Phone number: 760-940-1836
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Mailing Address
Mr. GREGORY NEIL MOFFETT
504 W VISTA WAY
VISTA, CA 92083-5704
Phone number: 760-940-1836
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