MICHEAL DEAN AXLEY RUSS

CHICO, CA
NPI1285170795
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-01-09
Last Update Date2017-01-09
Business Address
-- MICHEAL DEAN AXLEY RUSS
590 RIO LINDO AVE
CHICO, CA 95926-1817
Phone number: 530-345-3491
Mailing Address
-- MICHEAL DEAN AXLEY RUSS
116 INNSBROOK WAY APT 13
CHICO, CA 95973-0257
Phone number: 530-300-6354