Most Relevant Information
Provider Data
| NPI Number: | 1003393992 |
| Provider Name: | JEREMY BUTTOLPH ROBSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/23/2018 |
| Last Updated: | 08/08/2018 |
Provider Practice Location
3845 AVOCADO SCHOOL RD
LA MESA
CA
91941
Practice Location Phone/Fax
| Phone: | 6195883653 |
| Fax: |
Provider Mailing Location
3845 AVOCADO SCHOOL RD
LA MESA
CA
919417319
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |