COLTON RYAN FISKE

GRASS VALLEY, CA
NPI1952106304
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence:   R1498650223)
Enumeration Date2025-02-18
Last Update Date2025-06-25
Business Address
COLTON RYAN FISKE RADT I
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-273-9541
Mailing Address
COLTON RYAN FISKE RADT I
406 SUNRISE AVE STE 105
ROSEVILLE, CA 95661-4145
Phone number: 530-273-9541