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1679256234
TYLER LEE FAGAN
SACRAMENTO, CA
NPI
1679256234
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-08-10
Last Update Date
2023-08-10
Business Address
TYLER LEE FAGAN
1300 ETHAN WAY STE 175
SACRAMENTO, CA 95825-2277
Phone number: 833-599-2560
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Mailing Address
TYLER LEE FAGAN
850 TOWBIN AVE
LAKEWOOD, NJ 08701-5928
Phone number: 833-599-2560
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