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1720106537
ROGER B WIFORD
FONTANA, CA
NPI
1720106537
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA CAADE 030817)
Enumeration Date
2007-03-27
Last Update Date
2007-07-08
Business Address
ROGER B WIFORD ADC
7993 SIERRA AVE
FONTANA, CA 92336-3330
Phone number: 909-822-8720
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Mailing Address
ROGER B WIFORD ADC
7956 SPOHN AVE
FONTANA, CA 92336-2851
Phone number: 909-356-8645
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