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1104275270
MATTHEW WILLIS
GRASS VALLEY, CA
NPI
1104275270
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1236930816)
Enumeration Date
2016-06-08
Last Update Date
2017-03-08
Business Address
-- MATTHEW WILLIS
180 SIERRA COLLEGE DR
GRASS VALLEY, CA 95945-5768
Phone number: 530-271-1140
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Mailing Address
-- MATTHEW WILLIS
180 SIERRA COLLEGE DR
GRASS VALLEY, CA 95945-5768
Phone number: 530-271-1140
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