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1598889529
JESUS FAVELA
MODESTO, CA
NPI
1598889529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-03-16
Last Update Date
2007-07-08
Business Address
-- JESUS FAVELA
1208 9TH ST
MODESTO, CA 95354-0713
Phone number: 209-558-4464
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Mailing Address
-- JESUS FAVELA
800 SCENIC DR
MODESTO, CA 95350-6131
Phone number: 209-558-4464
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