person
Marie Antionette Jefferson
Addiction (Substance Use Disorder) Counselor in Santa Rosa, California
NPI 1144539495

Marie Antionette Jefferson is an Addiction (Substance Use Disorder) Counselor based in Santa Rosa, CA and is specialized in Addiction (Substance Use Disorder). Marie Antionette Jefferson practices in Santa Rosa, CA. The NPI Number for Marie Antionette Jefferson is 1144539495 and holds a License No. (California).

The current practice location address for Marie Antionette Jefferson is 98 Hendley St, Santa Rosa, CA and can be reached out via phone at 707-527-0712 and via fax at 707-527-6048.

Location: 98 Hendley St, Santa Rosa, CA, 95404-5025
person
Provider Profile Details
NPI Number
1144539495
Provider Name
Marie Antionette Jefferson
Credential
Provider Entity Type
Individual
Gender
Female
Address
98 Hendley St, Santa Rosa, CA, 95404-5025
Phone Number
707-527-0712
Fax Number
707-527-6048
Provider Enumeration Date
10/05/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6789 01 CA MEDICAL
institution
Provider Business Practice Location Address Details
Address
98 Hendley St
City
State
Zip
95404-5025
Phone Number
707-527-0712
Fax Number
707-527-6048
person
Provider Business Mailing Address Details
Address
98 Hendley St
City
State
Zip
95404-5025
Phone Number
707-527-0712
Fax Number
707-527-6048
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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