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1174669238
PAUL DWAYNE JOHNSON
SAN RAFAEL, CA
NPI
1174669238
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-01-29
Last Update Date
2007-07-08
Business Address
-- PAUL DWAYNE JOHNSON
914 MISSION AVE
SAN RAFAEL, CA 94901-6106
Phone number: 415-457-6964
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Mailing Address
-- PAUL DWAYNE JOHNSON
248 LAUREL PL
SAN RAFAEL, CA 94901-2011
Phone number:
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