JAY EL TILLMAN

CLEARLAKE, CA
NPI1154501047
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  RS2684)
Enumeration Date2007-11-07
Last Update Date2007-11-07
Business Address
-- JAY EL TILLMAN
6885 OLD HWY 53
CLEARLAKE, CA 95422
Phone number: 707-995-3235
Mailing Address
-- JAY EL TILLMAN
6840 S CENTER DR
CLEARLAKE, CA 95422-8134
Phone number: 707-995-1232
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