JERETT LEWIS DIAMOND

SOUTH LAKE TAHOE, CA
NPI1356521934
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-11-12
Last Update Date2007-11-12
Business Address
-- JERETT LEWIS DIAMOND
1137 EMERALD BAY RD
SOUTH LAKE TAHOE, CA 96150-6207
Phone number: 530-541-5190
Mailing Address
-- JERETT LEWIS DIAMOND
3790 PARADISE AVE UNIT A
SOUTH LAKE TAHOE, CA 96150-8536
Phone number:
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