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1003093394
GEOFF BLAYLOCK
SANTA ANA, CA
NPI
1003093394
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-01-29
Last Update Date
2008-01-29
Business Address
-- GEOFF BLAYLOCK
1905 COLLEGE AVE
SANTA ANA, CA 92706-2334
Phone number: 714-479-0120
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Mailing Address
-- GEOFF BLAYLOCK
1905 COLLEGE AVE
SANTA ANA, CA 92706-2334
Phone number: 714-479-0120
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