Tyndall Gene Elliott, CATC I
Counselor, Addiction (Substance Use Disorder) in Fresno, CA. Individual provider (NPI-1).
NPI number1861744690
StatusActive
Last updated in NPPESAug 24, 2016
Details
- NPI
- 1861744690
- Entity type
- Individual (NPI-1)
- Name
- Mr. Tyndall Gene Elliott
- Credential
- CATC I
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2012
- Last updated
- Aug 24, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 122909 | CA | Yes |
Practice location
2772 S. Martin Luther King Blvd.Fresno, CA 93706
Phone 559-265-4800 · Fax 559-265-4823
Mailing address
2772 Martin Luther King Jr. Blvd.Fresno, CA 93706
Phone 559-265-4800 · Fax 559-265-4823
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