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1417238346
MICHAEL WAYNE LEACH
SAN RAFAEL, CA
NPI
1417238346
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 03-035567)
Enumeration Date
2011-09-06
Last Update Date
2011-09-06
Business Address
Mr. MICHAEL WAYNE LEACH
1601 2ND ST
SAN RAFAEL, CA 94901-2712
Phone number: 415-456-6655
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Mailing Address
Mr. MICHAEL WAYNE LEACH
135 WALNUT CIR
ROHNERT PARK, CA 94928-2655
Phone number: 707-849-1949
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