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1548388010
GORDON ANTONELLI GRANT
HAYWARD, CA
NPI
1548388010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-03-26
Last Update Date
2007-07-08
Business Address
-- GORDON ANTONELLI GRANT
22262 S GARDEN AVE APT 104
HAYWARD, CA 94541-6025
Phone number: 510-978-9655
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Mailing Address
-- GORDON ANTONELLI GRANT
22262 S GARDEN AVE APT 104
HAYWARD, CA 94541-6025
Phone number: 510-978-9655
Copy
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