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1427498336
LARRY MALONE POWELL
SACRAMENTO, CA
NPI
1427498336
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA RW7223)
Enumeration Date
2013-06-25
Last Update Date
2013-06-25
Business Address
Mr. LARRY MALONE POWELL
4343 WILLIAMSBOURGH DRIVE
SACRAMENTO, CA 95823
Phone number: 916-395-3552
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Mailing Address
Mr. LARRY MALONE POWELL
4343 WILLIAMSBOURGH DR
SACRAMENTO, CA 95823-2006
Phone number: 916-395-3552
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