THEODORE EDWARD ANDERSON

STOCKTON, CA
NPI1184842833
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-04-20
Last Update Date2007-07-08
Business Address
Mr. THEODORE EDWARD ANDERSON
1839 S EL DORADO ST
STOCKTON, CA 95206-2025
Phone number: 209-463-0872
Mailing Address
Mr. THEODORE EDWARD ANDERSON
1191 BRIDGETON AVE
MANTECA, CA 95336-2938
Phone number: 209-346-4034
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