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1154713766
LEEROY WAINWRIGHT
SAN PABLO, CA
NPI
1154713766
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-02-19
Last Update Date
2015-02-19
Business Address
-- LEEROY WAINWRIGHT
1515 MARKET AVE
SAN PABLO, CA 94806-4357
Phone number: 510-232-7571
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Mailing Address
-- LEEROY WAINWRIGHT
1515 MARKET AVE
SAN PABLO, CA 94806-4357
Phone number: 510-232-7571
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