JON VAN RADER

BROCKTON, MA
NPI1740604008
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MA  11760)
Enumeration Date2014-02-06
Last Update Date2014-08-07
Business Address
-- JON VAN RADER LADC
425 PLEASANT ST
BROCKTON, MA 02301-2533
Phone number: 508-272-7561
Mailing Address
-- JON VAN RADER LADC
425 PLEASANT ST
BROCKTON, MA 02301-2533
Phone number: 508-272-7561
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