Individual
BRYAN ANDRE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 SPEERS RD, SANTA ROSA, CA 95409-3123
(707) 571-2215
(707) 526-9672
Mailing address
PO BOX 2587, SANTA ROSA, CA 95405-0587
(707) 571-2215
(707) 526-9672
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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