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1144539495
MARIE ANTIONETTE JEFFERSON
SANTA ROSA, CA
NPI
1144539495
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-10-05
Last Update Date
2016-02-26
Business Address
-- MARIE ANTIONETTE JEFFERSON
98 HENDLEY ST
SANTA ROSA, CA 95404-5025
Phone number: 707-527-0712
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Mailing Address
-- MARIE ANTIONETTE JEFFERSON
98 HENDLEY ST
SANTA ROSA, CA 95404-5025
Phone number: 707-527-0712
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