Organization
SHEEPDOG FITNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER ANN TELFORD MSK (PRESIDENT)
(949) 291-1283
Entity
Organization
Contact information
Practice address
34207 PACIFIC COAST HWY STE A, DANA POINT, CA 92629-2849
(949) 291-1283
Mailing address
34207 PACIFIC COAST HWY STE A, DANA POINT, CA 92629-2849
(949) 291-1283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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