TIM FARRELLY

FLAGSTAFF, AZ
NPI1407868615
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LISAC-10411)
Enumeration Date2006-08-13
Last Update Date2007-07-08
Business Address
-- TIM FARRELLY MS
2187 N VICKEY ST
FLAGSTAFF, AZ 86004-6106
Phone number: 928-714-6401
Mailing Address
-- TIM FARRELLY MS
2187 N VICKEY ST
FLAGSTAFF, AZ 86004-6106
Phone number: 928-714-6401
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