MEDICARE: MIKE HARLING RAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	H0906092046	CA

General Provider Information

NPI Number	:	1841541240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKE HARLING RAS

Provider Business Mailing Address
First Line	:	285 4TH ST
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95695-3501
Country	:	US
Telephone Number	:	530-662-2699
Fax Number	:

Provider Business Practice Location Address
First Line	:	285 4TH ST
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95695-3501
Country	:	US
Telephone Number	:	530-662-2699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	09/25/2012

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