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1376391995
MARTELL TRAVONE BYRD
FAIRFIELD, CA
NPI
1376391995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1550910224)
Enumeration Date
2024-05-08
Last Update Date
2024-05-08
Business Address
MARTELL TRAVONE BYRD
623 GREAT JONES ST
FAIRFIELD, CA 94533-6005
Phone number: 707-664-7798
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Mailing Address
MARTELL TRAVONE BYRD
623 GREAT JONES ST
FAIRFIELD, CA 94533-6005
Phone number: 707-664-7798
Copy
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