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1689456717
GARY JOSEPH BETTENCOURT
MODESTO, CA
NPI
1689456717
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA 9127)
Enumeration Date
2023-10-13
Last Update Date
2023-10-18
Business Address
MR. GARY JOSEPH BETTENCOURT SUDCC
1101 SYLVAN AVE STE C103
MODESTO, CA 95350-1687
Phone number: 209-758-7477
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Mailing Address
MR. GARY JOSEPH BETTENCOURT SUDCC
1101 SYLVAN AVE STE C103
MODESTO, CA 95350-1687
Phone number: 209-758-7477
Copy
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