GARY FEDOROFF

SAN RAFAEL, CA
NPI1093036717
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2010-06-16
Last Update Date2010-06-16
Business Address
Mr. GARY FEDOROFF
171 CARLOS DR
SAN RAFAEL, CA 94903-2005
Phone number: 415-755-2310
Mailing Address
Mr. GARY FEDOROFF
171 CARLOS DR
SAN RAFAEL, CA 94903-2005
Phone number: 415-755-2310