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BAKERSFIELD, CA
NPI1790935054
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2008-09-23
Last Update Date2008-09-23
Business Address
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3628 STOCKDALE HWY
BAKERSFIELD, CA 93309-2153
Phone number: 661-322-1021
Mailing Address
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6109 MANAGUA DR
BAKERSFIELD, CA 93313-5114
Phone number: