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1134507924
AUDY DALE DAVIS
SAN BERNARDINO, CA
NPI
1134507924
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-05-12
Last Update Date
2015-05-18
Business Address
-- AUDY DALE DAVIS
1874 BUSINESS CENTER DR
SAN BERNARDINO, CA 92408-3457
Phone number: 909-386-0523
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Mailing Address
-- AUDY DALE DAVIS
6564 LYNWOOD WAY
HIGHLAND, CA 92346-2333
Phone number: 541-551-1028
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