Most Relevant Information
Provider Data
| NPI Number: | 1003690751 |
| Provider Name: | WILLIE R MEADOWS SUD COUNSELOR |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 15171 |
Most Important Dates
| Enumeration Date: | 08/23/2023 |
| Last Updated: | 08/23/2023 |
Provider Practice Location
4660 EL CAJON BLVD STE 210
SAN DIEGO
CA
921154466
Practice Location Phone/Fax
| Phone: | 6195977335 |
| Fax: | 6196422735 |
Provider Mailing Location
4660 EL CAJON BLVD STE 210
SAN DIEGO
CA
921154466
Provider Mailing Phone/Fax
| Phone: | 6195977335 |
| Fax: | 6196422735 |