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1134345424
JUSTIN JAY WYLIE
SAN DIEGO, CA
NPI
1134345424
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-17
Last Update Date
2007-07-08
Business Address
Mr. JUSTIN JAY WYLIE
3274 ROSECRANS ST
SAN DIEGO, CA 92110-4836
Phone number: 619-226-2663
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Mailing Address
Mr. JUSTIN JAY WYLIE
3274 ROSECRANS ST
SAN DIEGO, CA 92110-4836
Phone number: 619-226-2663
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