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1053812883
RAEVAN MONICA SHEPHERD
UKIAH, CA
NPI
1053812883
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-02-27
Last Update Date
2019-01-10
Business Address
RAEVAN MONICA SHEPHERD RAS
201 BRUSH ST
UKIAH, CA 95482-3424
Phone number: 707-462-6290
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Mailing Address
RAEVAN MONICA SHEPHERD RAS
2681 LAKESHORE BLVD APT 7
LAKEPORT, CA 95453-6971
Phone number: 707-295-2304
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