MICHAEL JUCKETT

SOUTH LAKE TAHOE, CA
NPI1629272869
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  CORPHQ-254-103011A)
Enumeration Date2007-06-12
Last Update Date2007-07-08
Business Address
Mr. MICHAEL JUCKETT
1137 EMERALD BAY RD
SOUTH LAKE TAHOE, CA 96150-6207
Phone number: 530-541-5190
Mailing Address
Mr. MICHAEL JUCKETT
PO BOX 16435
SOUTH LAKE TAHOE, CA 96151-6435
Phone number: 530-208-8171
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