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1083988018
COREY RAYMOND WAKEN
NAPA, CA
NPI
1083988018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2012-03-08
Last Update Date
2012-03-08
Business Address
COREY RAYMOND WAKEN
2100 NAPA VALLEJO HWY BLDG M1&M2
NAPA, CA 94558-6234
Phone number: 707-257-1460
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Mailing Address
COREY RAYMOND WAKEN
2100 NAPA VALLEJO HWY P.O. BOX 7026
NAPA, CA 94558-6234
Phone number: 707-257-1460
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