JACK ROY BOHANON

PALO ALTO, CA
NPI1508947706
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: CA  MFC29822)
Additional Taxonomies106H00000X Marriage & Family Therapist
(Licence: CA  MFC29822)
Enumeration Date2006-10-17
Last Update Date2007-07-08
Business Address
MR. JACK ROY BOHANON MFT
703 WELCH RD STE. F6
PALO ALTO, CA 94304-1710
Phone number: 650-599-2262
Mailing Address
MR. JACK ROY BOHANON MFT
123 GLADYS AVE
MOUNTAIN VIEW, CA 94043-3967
Phone number: 650-599-2262