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1548803208
JEREMY MARTIN TIETZ
CHICO, CA
NPI
1548803208
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2019-10-24
Last Update Date
2019-10-24
Business Address
MR. JEREMY MARTIN TIETZ
560 COHASSET RD STE 180
CHICO, CA 95926-2460
Phone number: 530-891-2810
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Mailing Address
MR. JEREMY MARTIN TIETZ
642 W 4TH AVE
CHICO, CA 95926-3707
Phone number: 530-354-8554
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