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1942889985
BRUCE ARLEN BENHAM
SAN RAFAEL, CA
NPI
1942889985
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-04-06
Last Update Date
2021-04-06
Business Address
Mr. BRUCE ARLEN BENHAM RADT
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-454-9444
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Mailing Address
Mr. BRUCE ARLEN BENHAM RADT
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-454-9444
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