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1568695245
RUDOLPHO EDUARDO DE LA O
SANTA ROSA, CA
NPI
1568695245
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA D0501021429)
Enumeration Date
2009-08-28
Last Update Date
2009-08-28
Business Address
-- RUDOLPHO EDUARDO DE LA O RAS
3315 AIRWAY DRIVE
SANTA ROSA, CA 95403
Phone number: 707-523-2242
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Mailing Address
-- RUDOLPHO EDUARDO DE LA O RAS
3315 AIRWAY DR
SANTA ROSA, CA 95403-2005
Phone number: 707-523-2242
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