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1316433089
ALLEN GERALD WOODHAM
VISTA, CA
NPI
1316433089
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-07-06
Last Update Date
2018-07-06
Business Address
ALLEN GERALD WOODHAM RADT1
991 POSTAL WAY APT 4
VISTA, CA 92083-6932
Phone number: 760-525-2656
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Mailing Address
ALLEN GERALD WOODHAM RADT1
993 POSTAL WAY
VISTA, CA 92083-6945
Phone number: 760-525-2656
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