RUSSELL DWAYNE STEPHEN

SACRAMENTO, CA
NPI1720563844
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-09-25
Last Update Date2018-09-25
Business Address
RUSSELL DWAYNE STEPHEN
4441 AUBURN BLVD STE E
SACRAMENTO, CA 95841-4139
Phone number: 916-473-5764
Mailing Address
RUSSELL DWAYNE STEPHEN
4441 AUBURN BLVD STE E
SACRAMENTO, CA 95841-4139
Phone number: 916-473-5764
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