KENNETH WISEMAN

GRASS VALLEY, CA
NPI1053905752
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  B00003980425)
Enumeration Date2021-02-23
Last Update Date2025-05-07
Business Address
KENNETH WISEMAN
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-460-4083
Mailing Address
KENNETH WISEMAN
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-460-4083
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