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1851741615
JEFFERY DETAR
RESEDA, CA
NPI
1851741615
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA 1711224)
Enumeration Date
2016-06-13
Last Update Date
2023-06-07
Business Address
JEFFERY DETAR CATC-III
7101 BAIRD AVE
RESEDA, CA 91335-4150
Phone number: 818-342-5897
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Mailing Address
JEFFERY DETAR CATC-III
7101 BAIRD AVE
RESEDA, CA 91335-4150
Phone number: 818-342-5897
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