WALTER PEDERSEN

SOUTH LAKE TAHOE, CA
NPI1730301128
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2007-05-03
Last Update Date2014-04-10
Business Address
WALTER PEDERSEN CADC II
2494 LAKE TAHOE BLVD STE B2
SOUTH LAKE TAHOE, CA 96150-7142
Phone number: 530-541-4594
Mailing Address
WALTER PEDERSEN CADC II
3668 SPRUCE AVE APT. 19
SOUTH LAKE TAHOE, CA 96150-7497
Phone number: 530-388-8085