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1093850703
NATHANIEL MARK TOLLEFSON
HEMET, CA
NPI
1093850703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2007-02-20
Last Update Date
2007-07-08
Business Address
MR. NATHANIEL MARK TOLLEFSON
650 N STATE ST
HEMET, CA 92543-2960
Phone number: 951-791-3350
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Mailing Address
MR. NATHANIEL MARK TOLLEFSON
1097 N STATE ST #162
HEMET, CA 92543-1514
Phone number: 951-652-7068
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