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1225604168
DWAYNE RUSSELL DORE
REDDING, CA
NPI
1225604168
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA A05120315)
Enumeration Date
2021-06-01
Last Update Date
2021-06-01
Business Address
DWAYNE RUSSELL DORE CADCII
376 HARTNELL AVE STE A
REDDING, CA 96002-1881
Phone number: 530-999-2626
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Mailing Address
DWAYNE RUSSELL DORE CADCII
376 HARTNELL AVE STE A
REDDING, CA 96002-1881
Phone number: 530-999-2626
Copy
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