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1720401367
ABRAHAM LEWIS CLARK
SANTA ROSA, CA
NPI
1720401367
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA RIC1401231658)
Enumeration Date
2014-02-03
Last Update Date
2014-02-03
Business Address
-- ABRAHAM LEWIS CLARK
1901 CLEVELAND AVENUE, #B SANTA ROSA TREATMENT PROGRAM
SANTA ROSA, CA 95401
Phone number: 707-576-0818
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Mailing Address
-- ABRAHAM LEWIS CLARK
1901 CLEVELAND AVENUE, #B SANTA ROSA TREATMENT PROGRAM
SANTA ROSA, CA 95401
Phone number: 707-576-0818
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