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1033847561
MICHAEL DEMETRIE PORTILLO
LOS ANGELES, CA
NPI
1033847561
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-08-11
Last Update Date
2022-08-11
Business Address
MICHAEL DEMETRIE PORTILLO
4322 WILSHIRE BLVD STE 104
LOS ANGELES, CA 90010-3737
Phone number: 323-879-4951
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Mailing Address
MICHAEL DEMETRIE PORTILLO
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number: 818-345-2345
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