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1164962841
JESSE POWELL
LANCASTER, CA
NPI
1164962841
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2017-03-01
Last Update Date
2017-03-01
Business Address
JESSE POWELL
44447 10TH ST W
LANCASTER, CA 93534-3324
Phone number: 661-726-2630
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Mailing Address
JESSE POWELL
1734 THOMAS DR
LANCASTER, CA 93535
Phone number: 661-874-2085
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