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1790128544
SAMUEL LAWRENCE BOUTIN
SAN LEANDRO, CA
NPI
1790128544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
172V00000X Community Health Worker
Enumeration Date
2013-04-11
Last Update Date
2014-07-31
Business Address
Mr. SAMUEL LAWRENCE BOUTIN
2275 ARLINGTON DR
SAN LEANDRO, CA 94578-1132
Phone number: 510-317-1444
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Mailing Address
Mr. SAMUEL LAWRENCE BOUTIN
2275 ARLINGTON DR
SAN LEANDRO, CA 94578-1132
Phone number: 510-317-1444
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