BLAISE RASTELLO

BOULDER, CO
NPI1366981458
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO  ACD.0001086)
Enumeration Date2017-02-22
Last Update Date2023-01-23
Business Address
BLAISE RASTELLO CAC II
4475 BROADWAY ST LOT 51
BOULDER, CO 80304-4350
Phone number: 720-391-9951
Mailing Address
BLAISE RASTELLO CAC II
4475 BROADWAY ST LOT 51
BOULDER, CO 80304-4350
Phone number: 720-391-9951
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