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1760256358
SA THAO
REDDING, CA
NPI
1760256358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-11-14
Last Update Date
2023-11-14
Business Address
SA THAO
3648 EL PORTAL DR
REDDING, CA 96002-3133
Phone number: 530-722-1114
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Mailing Address
SA THAO
3648 EL PORTAL DR
REDDING, CA 96002-3133
Phone number: 530-722-1114
Copy
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