| NPI | 1245833524 |
|---|---|
| Other Name | DRETONA T. MADDOX, LICENSED CLINICAL SOCIAL WORKER |
| Entity Type | Organization |
| Authorized Contact | DRETONA T. MADDOX Nurse Social Work Practitioner 909-471-0697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-20 |