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1548820095
LORA RENEE DOUGLAS
FREMONT, CA
NPI
1548820095
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1332031218)
Enumeration Date
2019-06-17
Last Update Date
2019-06-17
Business Address
Mrs. LORA RENEE DOUGLAS RADT
37437 GLENMOOR DR
FREMONT, CA 94536-5731
Phone number: 510-713-3200
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Mailing Address
Mrs. LORA RENEE DOUGLAS RADT
4510 PERALTA BLVD STE 1
FREMONT, CA 94536-5755
Phone number: 510-713-3202
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