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1346957461
DONOVAN DETTLE
SANTA CRUZ, CA
NPI
1346957461
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2022-10-28
Last Update Date
2022-12-28
Business Address
DONOVAN DETTLE
530 SOQUEL AVE
SANTA CRUZ, CA 95062-2301
Phone number: 831-426-7322
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Mailing Address
DONOVAN DETTLE
PO BOX 214
APTOS, CA 95001-0214
Phone number:
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