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1205462934
TYLER JOHNSON
GRASS VALLEY, CA
NPI
1205462934
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-03-13
Last Update Date
2020-03-13
Business Address
TYLER JOHNSON
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-271-1140
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Mailing Address
TYLER JOHNSON
PO BOX 6028
AUBURN, CA 95604-6028
Phone number:
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