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1952763724
DONALD LEE MERRIAM
SAN RAFAEL, CA
NPI
1952763724
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA Ci06291016)
Enumeration Date
2016-03-22
Last Update Date
2017-02-15
Business Address
-- DONALD LEE MERRIAM
603 D STREET
SAN RAFAEL, CA 94901
Phone number: 415-454-9444
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Mailing Address
-- DONALD LEE MERRIAM
722 ASTON AVENUE
SANTA ROSA, CA 95404
Phone number: 951-704-2791
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