TRACY DANIEL CAMPBELL

SHASTA LAKE, CA
NPI1861753493
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  03-084213)
Enumeration Date2012-05-30
Last Update Date2012-05-30
Business Address
Mr. TRACY DANIEL CAMPBELL CAS
5010 SHASTA DAM BLVD
SHASTA LAKE, CA 96019-9406
Phone number: 530-275-1076
Mailing Address
Mr. TRACY DANIEL CAMPBELL CAS
5010 SHASTA DAM BLVD
SHASTA LAKE, CA 96019-9406
Phone number: 530-275-1076
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