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1558197426
TYRUS AUTUMN WILSON
YREKA, CA
NPI
1558197426
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-09-09
Last Update Date
2024-09-09
Business Address
TYRUS AUTUMN WILSON
2060 CAMPUS DR
YREKA, CA 96097-9538
Phone number: 530-841-4704
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Mailing Address
TYRUS AUTUMN WILSON
2060 CAMPUS DR
YREKA, CA 96097-9538
Phone number: 530-841-4704
Copy
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