Individual provider · Type 1 NPI

Gary Fedoroff

Addiction (Substance Use Disorder) Counselor · San Rafael, CA

NPI number 1093036717 Active

Practice location

171 Carlos Dr
San Rafael, CA 94903-2005

Call (415) 755-2310 Map

Fax (415) 755-2210

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1093036717

Gary Fedoroff's National Provider Identifier is 1093036717, issued on Jun 16, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Rafael, CA. The record was last updated on Jun 16, 2010.