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1184850125
KEVIN HURLEY BASCOM
SAN LUIS OBISPO, CA
NPI
1184850125
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-06-04
Last Update Date
2009-06-04
Business Address
Mr. KEVIN HURLEY BASCOM
277 SOUTH ST STE Y
SAN LUIS OBISPO, CA 93401-5039
Phone number: 805-541-5144
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Mailing Address
Mr. KEVIN HURLEY BASCOM
PO BOX 15408
SAN LUIS OBISPO, CA 93406-5408
Phone number: 805-541-5144
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