Individual provider · Type 1 NPI

Jennifer Dethlefsen

Addiction (Substance Use Disorder) Counselor · Upland, CA

NPI number 1861808628 Active

Practice location

916 N Mountain Ave, Suite A
Upland, CA 91786-3697

Call (909) 932-1069 Map

Fax (909) 932-1087

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1861808628

Jennifer Dethlefsen's National Provider Identifier is 1861808628, issued on Jul 1, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Upland, CA. The record was last updated on Jul 1, 2014.