| NPI | 1366171696 |
|---|---|
| Other Name | RAYMOND MANUEL BANDA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 11134) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2022-12-29 |