Mr. Gary Fedoroff
Mr. Gary Fedoroff is an Addiction (Substance Use Disorder) Counselor in San Rafael, California. Registered with an NPI since 2010.
- In the registry since
- 2010
Practice location Address checks out
171 Carlos DrSan Rafael, CA 94903-2005
Phone: (415) 755-2310
Fax: (415) 755-2210
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X |
|---|
Record details
| NPI number | 1093036717 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 16, 2010 |
| Last updated in NPPES | June 16, 2010 |
| Mailing address | 171 Carlos Dr, San Rafael, CA 94903-2005 |
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