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1689166969
CRYSTAL MARIE DEATHERAGE
ESCONDIDO, CA
NPI
1689166969
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-06-03
Last Update Date
2020-10-21
Business Address
CRYSTAL MARIE DEATHERAGE
1341 N ESCONDIDO BLVD
ESCONDIDO, CA 92026-2507
Phone number: 760-844-7314
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Mailing Address
CRYSTAL MARIE DEATHERAGE
1341 N ESCONDIDO BLVD
ESCONDIDO, CA 92026-2507
Phone number: 760-844-4317
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