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1295568483
JACQUELYN ANETTE VAN BUREN
FAIRFIELD, CA
NPI
1295568483
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1568820724)
Enumeration Date
2024-08-22
Last Update Date
2024-08-22
Business Address
JACQUELYN ANETTE VAN BUREN RADT
1234 TRAVIS BLVD
FAIRFIELD, CA 94533-4802
Phone number: 707-718-4872
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Mailing Address
JACQUELYN ANETTE VAN BUREN RADT
609 JEFFERSON ST
FAIRFIELD, CA 94533-6293
Phone number: 707-718-4872
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