ALLEN GERALD WOODHAM

VISTA, CA
NPI1316433089
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-07-06
Last Update Date2018-07-06
Business Address
ALLEN GERALD WOODHAM RADT1
991 POSTAL WAY APT 4
VISTA, CA 92083-6932
Phone number: 760-525-2656
Mailing Address
ALLEN GERALD WOODHAM RADT1
993 POSTAL WAY
VISTA, CA 92083-6945
Phone number: 760-525-2656