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1326794256
NATHAN GIST
SAN RAFAEL, CA
NPI
1326794256
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-03-01
Last Update Date
2022-03-01
Business Address
NATHAN GIST
291 SMITH RANCH RD
SAN RAFAEL, CA 94903-2093
Phone number: 415-492-0818
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Mailing Address
NATHAN GIST
291 SMITH RANCH RD
SAN RAFAEL, CA 94903-2093
Phone number: 415-492-0818
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