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1194187625
MIZRAIN VAZQUEZ
GRANTS PASS, OR
NPI
1194187625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 13-12-43)
Enumeration Date
2016-03-23
Last Update Date
2016-03-23
Business Address
-- MIZRAIN VAZQUEZ CADC I
510 NW 4TH ST
GRANTS PASS, OR 97526-2078
Phone number: 541-474-5196
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Mailing Address
-- MIZRAIN VAZQUEZ CADC I
510 NW 4TH ST
GRANTS PASS, OR 97526-2078
Phone number: 541-474-5196
Copy
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