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1154102358
EDWARD DISHART
SACRAMENTO, CA
NPI
1154102358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 15471)
Enumeration Date
2023-10-12
Last Update Date
2023-10-12
Business Address
EDWARD DISHART
3600 POWER INN RD
SACRAMENTO, CA 95826-3826
Phone number: 916-450-0700
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Mailing Address
EDWARD DISHART
3600 POWER INN RD
SACRAMENTO, CA 95826-3826
Phone number: 916-450-0700
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