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1255725495
EARL BOISCLAIR
SANTA ROSA, CA
NPI
1255725495
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-03-25
Last Update Date
2015-03-25
Business Address
-- EARL BOISCLAIR
2470 LEMUR ST
SANTA ROSA, CA 95401-6743
Phone number: 707-479-9517
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Mailing Address
-- EARL BOISCLAIR
2470 LEMUR ST
SANTA ROSA, CA 95401-6743
Phone number:
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