DOMINIQUE TERRELL PETTIS

COLTON, CA
NPI1184968570
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2012-11-26
Last Update Date2012-11-26
Business Address
-- DOMINIQUE TERRELL PETTIS
2275 E. COOLEY DR
COLTON, CA 92324
Phone number: 909-370-1777
Mailing Address
-- DOMINIQUE TERRELL PETTIS
16519 WELSH CT
MORENO VALLEY, CA 92555-3316
Phone number: 951-566-6291
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