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1609641810
JEREMY BLAKE NASH
SANTA ROSA, CA
NPI
1609641810
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 15720)
Enumeration Date
2023-11-17
Last Update Date
2023-11-17
Business Address
JEREMY BLAKE NASH SUDRC
2403 PROFESSIONAL DR STE 103
SANTA ROSA, CA 95403-3007
Phone number: 707-526-2999
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Mailing Address
JEREMY BLAKE NASH SUDRC
2403 PROFESSIONAL DR STE 103
SANTA ROSA, CA 95403-3007
Phone number: 707-526-2999
Copy
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