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1124731575
MICHAEL LAWRENCE CHERVENY
SAN RAFAEL, CA
NPI
1124731575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-12-30
Last Update Date
2022-12-30
Business Address
MICHAEL LAWRENCE CHERVENY SUDRC
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 707-331-5575
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Mailing Address
MICHAEL LAWRENCE CHERVENY SUDRC
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 707-331-5575
Copy
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