JACK PAUL TALLY

SAN DIEGO, CA
NPI1790256527
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  A052360521)
Enumeration Date2018-12-05
Last Update Date2026-03-26
Business Address
JACK PAUL TALLY
1530 DALE ST
SAN DIEGO, CA 92102-1519
Phone number: 619-915-5710
Mailing Address
JACK PAUL TALLY
1530 DALE ST
SAN DIEGO, CA 92102-1519
Phone number: 619-915-5710
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