Individual
JAY L ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 E CANAL DR, TURLOCK, CA 95380-3936
(209) 669-2583
Mailing address
12155 CHAD LN, WATERFORD, CA 95386-9400
(209) 683-9026
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
61017
CA
Other
Enumeration date
09/03/2009
Last updated
10/22/2012
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