BLAKE ANDREW SHUPE

UKIAH, CA
NPI1609359090
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  7581)
Enumeration Date2018-09-11
Last Update Date2018-09-11
Business Address
BLAKE ANDREW SHUPE AOD Counselor
201 BRUSH ST
UKIAH, CA 95482-3424
Phone number: 707-462-6290
Mailing Address
BLAKE ANDREW SHUPE AOD Counselor
2365 ROAD E
REDWOOD VALLEY, CA 95470-9517
Phone number: 707-462-6290
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