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1821528472
JEDEDIAH CHARLES BEALL
SANTA ROSA, CA
NPI
1821528472
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-06-15
Last Update Date
2017-06-15
Business Address
JEDEDIAH CHARLES BEALL
440 ARROWOOD DR
SANTA ROSA, CA 95407-7503
Phone number: 707-284-2950
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Mailing Address
JEDEDIAH CHARLES BEALL
2727 CANTERBURY DR
SANTA ROSA, CA 95405-8540
Phone number: 707-479-8697
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