JACOB WILDING AVERY

SAN DIEGO, CA
NPI1558639989
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  27985)
Enumeration Date2011-12-13
Last Update Date2011-12-13
Business Address
Mr. JACOB WILDING AVERY LCSW
4258 HAWK ST
SAN DIEGO, CA 92103-1357
Phone number: 619-727-7167
Mailing Address
Mr. JACOB WILDING AVERY LCSW
4258 HAWK ST
SAN DIEGO, CA 92103-1357
Phone number: 619-727-7167
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