Individual
BLAKE BUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1807 ORCHARD ST, SANTA ROSA, CA 95404-2444
(707) 490-5442
Mailing address
1807 ORCHARD ST, SANTA ROSA, CA 95404-2444
(707) 490-5442
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23151
CA
Other
Enumeration date
06/18/2022
Last updated
11/10/2022
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