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REGAN BAUDENDISTEL

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1114558186

Individual Registrant:
 REGAN  BAUDENDISTEL 
Gender: M
Sole Proprietor

Location and contact information for practice:
47 SIR FRANCIS DRAKE BLVD  ROSS, CA 94957-9601 US
Tel: 818-926-8401  Fax: --

Contact information for business:
PO BOX 1446  ROSS, CA 94957-1446 US
Tel: 818-926-8401  Fax: --

Registration Information:
NPI: 1114558186
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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