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1053822841
KEVIN AUSTIN CHURCHILL
STOCKTON, CA
NPI
1053822841
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 40640)
Enumeration Date
2017-10-19
Last Update Date
2017-10-19
Business Address
KEVIN AUSTIN CHURCHILL
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-0102
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Mailing Address
KEVIN AUSTIN CHURCHILL
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-0102
Copy
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