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1760947485
KYLE BATTAGLIA FAIRCLOTH
BERKELEY, CA
NPI
1760947485
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1328421118)
Enumeration Date
2019-02-06
Last Update Date
2019-02-06
Business Address
Mr. KYLE BATTAGLIA FAIRCLOTH
1820 SCENIC AVE
BERKELEY, CA 94709-1324
Phone number: 510-548-7270
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Mailing Address
Mr. KYLE BATTAGLIA FAIRCLOTH
558 CLAYTON AVE
EL CERRITO, CA 94530-3230
Phone number: 510-860-3794
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