NICHOLAS BLAKE

FULLERTON, CA
NPI1548922537
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1446301021)
Enumeration Date2021-10-07
Last Update Date2021-10-07
Business Address
NICHOLAS BLAKE RADT
771 W ORANGETHORPE AVE
FULLERTON, CA 92832-2806
Phone number: 714-879-0929
Mailing Address
NICHOLAS BLAKE RADT
771 W ORANGETHORPE AVE
FULLERTON, CA 92832-2806
Phone number: 714-879-0929