Individual
DR. JARED ALAN DETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
338 S DAKOTA AVE, VANDENBERG AFB, CA 93437-6307
(805) 606-8217
Mailing address
338 S DAKOTA AVE, VANDENBERG AFB, CA 93437-6307
(805) 606-8217
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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