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1194956946
EDWARD LEROY CRANDELL
ANTIOCH, CA
NPI
1194956946
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 9187)
Enumeration Date
2009-07-28
Last Update Date
2009-07-28
Business Address
-- EDWARD LEROY CRANDELL CAS
1408 A ST
ANTIOCH, CA 94509-2331
Phone number: 925-978-2873
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Mailing Address
-- EDWARD LEROY CRANDELL CAS
1408 A ST
ANTIOCH, CA 94509-2331
Phone number: 925-978-2873
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