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1003147562
MICHAEL GONG
WATSONVILLE, CA
NPI
1003147562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-01-22
Last Update Date
2010-01-22
Business Address
-- MICHAEL GONG
335 E LAKE AVE
WATSONVILLE, CA 95076-4826
Phone number: 831-728-6445
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Mailing Address
-- MICHAEL GONG
335 E LAKE AVE
WATSONVILLE, CA 95076-4826
Phone number: 831-728-6445
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