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1568968048
GARY CHALON MOON
LINCOLN, CA
NPI
1568968048
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-04-03
Last Update Date
2018-04-03
Business Address
Mr. GARY CHALON MOON
385 LILAC LN
LINCOLN, CA 95648-8165
Phone number: 916-708-7557
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Mailing Address
Mr. GARY CHALON MOON
385 LILAC LN
LINCOLN, CA 95648-8165
Phone number: 916-708-7557
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