SHANE MICHAEL SHORT

SANTA ROSA, CA
NPI1528625738
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-05-22
Last Update Date2019-05-22
Business Address
SHANE MICHAEL SHORT
2403 PROFESSIONAL DR
SANTA ROSA, CA 95403-3007
Phone number: 707-544-3295
Mailing Address
SHANE MICHAEL SHORT
2403 PROFESSIONAL DR
SANTA ROSA, CA 95403-3007
Phone number: 707-544-3295
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