ROLAND RAOUL PARENT

LOGAN, UT
NPI1710193966
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT  5180258-6006)
Enumeration Date2007-05-15
Last Update Date2007-07-08
Business Address
-- ROLAND RAOUL PARENT
655 E 1300 N
LOGAN, UT 84341
Phone number: 435-792-6500
Mailing Address
-- ROLAND RAOUL PARENT
655 E 1300 N
LOGAN, UT 84341
Phone number: 435-792-6500