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1639884133
EYOB FANTAY
CHULA VISTA, CA
NPI
1639884133
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1448371021)
Enumeration Date
2023-01-18
Last Update Date
2023-01-18
Business Address
EYOB FANTAY RADT
73 N 2ND AVE STE B
CHULA VISTA, CA 91910-1124
Phone number: 619-426-4801
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Mailing Address
EYOB FANTAY RADT
73 N 2ND AVE STE B
CHULA VISTA, CA 91910-1124
Phone number: 619-426-4801
Copy
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