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1700200730
GARY DIAZ
SAN BERNARDINO, CA
NPI
1700200730
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA 360004BV)
Enumeration Date
2014-02-11
Last Update Date
2014-02-11
Business Address
GARY DIAZ
1100 N D ST
SAN BERNARDINO, CA 92410-3524
Phone number: 909-884-0840
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Mailing Address
GARY DIAZ
1100 N D ST
SAN BERNARDINO, CA 92410-3524
Phone number: 909-884-0840
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