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1760264915
DAVID RAESE
MODESTO, CA
NPI
1760264915
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 15389)
Enumeration Date
2023-10-20
Last Update Date
2023-10-20
Business Address
DAVID RAESE SUDRC#15389
1101 SYLVAN AVE STE C103
MODESTO, CA 95350-1687
Phone number: 209-758-7477
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Mailing Address
DAVID RAESE SUDRC#15389
1101 SYLVAN AVE STE C103
MODESTO, CA 95350-1687
Phone number: 209-758-7477
Copy
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