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1972963759
BRAD TERRY
VICTORVILLE, CA
NPI
1972963759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1223870316)
Enumeration Date
2016-03-07
Last Update Date
2016-03-07
Business Address
-- BRAD TERRY
16248 VICTOR ST
VICTORVILLE, CA 92395-3934
Phone number: 760-243-7151
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Mailing Address
-- BRAD TERRY
16248 VICTOR ST
VICTORVILLE, CA 92395-3934
Phone number: 760-243-7151
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