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1750582615
GLENN DALE PAULSON
SANTA ROSA, CA
NPI
1750582615
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-29
Last Update Date
2007-07-08
Business Address
-- GLENN DALE PAULSON RASi
440 ARROWOOD DR
SANTA ROSA, CA 95407-7503
Phone number: 707-284-2955
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Mailing Address
-- GLENN DALE PAULSON RASi
440 ARROWOOD DR
SANTA ROSA, CA 95407-7503
Phone number: 707-284-2955
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