RICHARD ALLAN DIWALD

LAKEPORT, CA
NPI1861558678
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  D0412282000)
Enumeration Date2006-12-28
Last Update Date2007-07-08
Business Address
-- RICHARD ALLAN DIWALD RAS
991 PARALLEL DR
LAKEPORT, CA 95453-5720
Phone number: 707-263-8162
Mailing Address
-- RICHARD ALLAN DIWALD RAS
10719B RANCHERIA RD
UPPER LAKE, CA 95485-9572
Phone number: 707-245-4624
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