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1679060230
WILLIAM ROBERT DAVIS
GRASS VALLEY, CA
NPI
1679060230
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1362390919)
Enumeration Date
2018-04-19
Last Update Date
2019-09-11
Business Address
WILLIAM ROBERT DAVIS RADT
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-271-1140
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Mailing Address
WILLIAM ROBERT DAVIS RADT
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-271-1140
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