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1972870640
DONALD WAYNE MARLATT
SAN RAFAEL, CA
NPI
1972870640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
(Licence: CA 03-097228)
Enumeration Date
2011-11-24
Last Update Date
2011-11-24
Business Address
-- DONALD WAYNE MARLATT ras
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-454-9444
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Mailing Address
-- DONALD WAYNE MARLATT ras
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-454-9444
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