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1366981458
BLAISE RASTELLO
BOULDER, CO
NPI
1366981458
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO ACD.0001086)
Enumeration Date
2017-02-22
Last Update Date
2023-01-23
Business Address
BLAISE RASTELLO CAC II
4475 BROADWAY ST LOT 51
BOULDER, CO 80304-4350
Phone number: 720-391-9951
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Mailing Address
BLAISE RASTELLO CAC II
4475 BROADWAY ST LOT 51
BOULDER, CO 80304-4350
Phone number: 720-391-9951
Copy
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