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1346586435
ADAM SHAWN VANDIVER
EL CAJON, CA
NPI
1346586435
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA RW6051)
Enumeration Date
2012-12-18
Last Update Date
2012-12-18
Business Address
ADAM SHAWN VANDIVER
545 N MAGNOLIA AVE
EL CAJON, CA 92020-3608
Phone number: 619-579-0947
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Mailing Address
ADAM SHAWN VANDIVER
545 N MAGNOLIA AVE
EL CAJON, CA 92020-3608
Phone number: 619-579-0947
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