RYAN DANIEL WALL

SANTA ROSA, CA
NPI1750672580
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2011-04-27
Last Update Date2011-04-27
Business Address
-- RYAN DANIEL WALL
429 SPEERS RD
SANTA ROSA, CA 95409-3123
Phone number: 707-571-2215
Mailing Address
-- RYAN DANIEL WALL
PO BOX 2587
SANTA ROSA, CA 95405-0587
Phone number: 707-571-2215