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1144784984
DELMAR DANA TILLIS
SAN RAFAEL, CA
NPI
1144784984
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-01-25
Last Update Date
2019-01-25
Business Address
DELMAR DANA TILLIS
603 D ST
SAN RAFAEL, CA 94901-3719
Phone number: 415-454-9444
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Mailing Address
DELMAR DANA TILLIS
2475 RAWSON ST
OAKLAND, CA 94601-5523
Phone number: 832-732-7626
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