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1376038471
SEAN TYSON ERTS
SAN DIEGO, CA
NPI
1376038471
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1293240318)
Enumeration Date
2018-06-30
Last Update Date
2018-06-30
Business Address
SEAN TYSON ERTS RADT
927 24TH ST
SAN DIEGO, CA 92102-2005
Phone number: 619-233-8054
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Mailing Address
SEAN TYSON ERTS RADT
1081 CAMINO DEL RIO S STE 129
SAN DIEGO, CA 92108-3544
Phone number: 619-297-5131
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