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1114198009
LARRY DONELL ERVIN
CHICO, CA
NPI
1114198009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-03-18
Last Update Date
2008-03-18
Business Address
-- LARRY DONELL ERVIN
592 RIO LINDO AVE
CHICO, CA 95926-1817
Phone number: 530-891-2775
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Mailing Address
-- LARRY DONELL ERVIN
808 W 2ND AVE APT 12
CHICO, CA 95926-4468
Phone number: 530-894-3603
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