QUINTIN BLAYLOCK

RIVERSIDE, CA
NPI1194349498
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  R1326201018)
Enumeration Date2020-06-02
Last Update Date2022-11-22
Business Address
QUINTIN BLAYLOCK
2743 ORANGE ST
RIVERSIDE, CA 92501-2503
Phone number: 951-788-9515
Mailing Address
QUINTIN BLAYLOCK
2743 ORANGE ST
RIVERSIDE, CA 92501-2538
Phone number: 951-788-9515