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1205047941
AMY ELIZABETH FOSSELL
SANTA ROSA, CA
NPI
1205047941
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-24
Last Update Date
2007-07-08
Business Address
-- AMY ELIZABETH FOSSELL
2403 PROFESSIONAL DR SUITE 103
SANTA ROSA, CA 95403-3007
Phone number: 707-526-2999
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Mailing Address
-- AMY ELIZABETH FOSSELL
2403 PROFESSIONAL DR SUITE 103
SANTA ROSA, CA 95403-3007
Phone number: 707-526-2999
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