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REGAN BAUDENDISTEL
>> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1114558186
Individual Registrant: REGAN BAUDENDISTEL
Gender: M
Sole Proprietor
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: --
Tel: 818-926-8401 Fax: --
Contact information for business:
PO BOX 1446 ROSS, CA 94957-1446 US
Tel: 818-926-8401 Fax: --
Tel: 818-926-8401 Fax: --
Registration Information:
NPI: 1114558186
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101Y00000X | Behavioral Health & Social Service Providers Counselor |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
