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1639414899
EVANGLIST CORY TAYLOR
CERES, CA
NPI
1639414899
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-11-29
Last Update Date
2023-09-27
Business Address
Mr. EVANGLIST CORY TAYLOR
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number: 209-541-2121
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Mailing Address
Mr. EVANGLIST CORY TAYLOR
1904 RICHLAND AVE
CERES, CA 95307
Phone number: 209-525-7466
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