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1376131136
MICHAEL ANTOINNE WORTHAM
SAN LEANDRO, CA
NPI
1376131136
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-01-07
Last Update Date
2021-01-07
Business Address
MICHAEL ANTOINNE WORTHAM
2035 FAIRMONT DR
SAN LEANDRO, CA 94578-1088
Phone number: 510-346-7836
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Mailing Address
MICHAEL ANTOINNE WORTHAM
2035 FAIRMONT DR
SAN LEANDRO, CA 94578-1088
Phone number: 510-346-7836
Copy
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