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1225300692
WAYNE B RICHARDSON
STOCKTON, CA
NPI
1225300692
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-02-01
Last Update Date
2012-02-01
Business Address
-- WAYNE B RICHARDSON
503 S PERSHING AVE
STOCKTON, CA 95203-3236
Phone number: 209-810-5864
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Mailing Address
-- WAYNE B RICHARDSON
503 S PERSHING AVE
STOCKTON, CA 95203-3236
Phone number: 209-810-5864
Copy
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