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1356507123
MICHAEL A KELLAM
PLEASANTON, CA
NPI
1356507123
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-07-31
Last Update Date
2008-07-31
Business Address
-- MICHAEL A KELLAM
4361 RAILROAD AVE
PLEASANTON, CA 94566-6611
Phone number: 925-201-6041
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Mailing Address
-- MICHAEL A KELLAM
4361 RAILROAD AVE
PLEASANTON, CA 94566-6611
Phone number: 925-201-6041
Copy
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