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1205140035
ROY VIVIAN TELLIS
BROOKLYN, NY
NPI
1205140035
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 16918)
Enumeration Date
2010-08-04
Last Update Date
2010-08-04
Business Address
-- ROY VIVIAN TELLIS CASAC
255 AVENUE W
BROOKLYN, NY 11223-5202
Phone number: 866-569-7233
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Mailing Address
-- ROY VIVIAN TELLIS CASAC
PO BOX 230060
BROOKLYN, NY 11223-0060
Phone number: 866-569-7233
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