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1265918833
KELLY RICHARD MCCLANAHAN
SAN DIEGO, CA
NPI
1265918833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-07-17
Last Update Date
2018-07-17
Business Address
Mr. KELLY RICHARD MCCLANAHAN RADT
4161 MARLBOROUGH AVE
SAN DIEGO, CA 92105-1412
Phone number: 619-282-7274
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Mailing Address
Mr. KELLY RICHARD MCCLANAHAN RADT
1081 CAMINO DEL RIO S STE 129
SAN DIEGO, CA 92108-3544
Phone number: 619-297-5131
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