| NPI | 1174916985 |
|---|---|
| Former Name | RAFAEL S GALLEGOS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA I3151011) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |