JEFFERY DETAR

RESEDA, CA
NPI1851741615
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  1711224)
Enumeration Date2016-06-13
Last Update Date2023-06-07
Business Address
JEFFERY DETAR CATC-III
7101 BAIRD AVE
RESEDA, CA 91335-4150
Phone number: 818-342-5897
Mailing Address
JEFFERY DETAR CATC-III
7101 BAIRD AVE
RESEDA, CA 91335-4150
Phone number: 818-342-5897