DEMETRIA A MACON

GARY, IN
NPI1295142594
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN  86000292a)
Enumeration Date2014-07-18
Last Update Date2014-07-18
Business Address
Mrs. DEMETRIA A MACON cadac ii; lac
1100 W. 6TH AVE
GARY, IN 46402
Phone number: 219-885-4264
Mailing Address
Mrs. DEMETRIA A MACON cadac ii; lac
1514 GLENWOOD AVE.
GRIFFITH, IN 46319
Phone number: 219-588-9223
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