ROGER B WIFORD

FONTANA, CA
NPI1720106537
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  CAADE 030817)
Enumeration Date2007-03-27
Last Update Date2007-07-08
Business Address
-- ROGER B WIFORD ADC
7993 SIERRA AVE
FONTANA, CA 92336-3330
Phone number: 909-822-8720
Mailing Address
-- ROGER B WIFORD ADC
7956 SPOHN AVE
FONTANA, CA 92336-2851
Phone number: 909-356-8645