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1205549490
JONATHAN PHILLIPS
FAIRFIELD, CA
NPI
1205549490
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-01-03
Last Update Date
2023-01-03
Business Address
JONATHAN PHILLIPS RAD-T
1525 UNION AVE
FAIRFIELD, CA 94533-5049
Phone number: 707-435-1804
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Mailing Address
JONATHAN PHILLIPS RAD-T
609 JEFFERSON ST
FAIRFIELD, CA 94533-6293
Phone number: 707-399-9190
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