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1043929755
KIYANIE CHAQUEZ FEDRICK
MARIETTA, GA
NPI
1043929755
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-11-21
Last Update Date
2022-11-21
Business Address
KIYANIE CHAQUEZ FEDRICK
1519 JOHNSON FERRY RD BLDG 10
MARIETTA, GA 30062-6409
Phone number: 866-523-4268
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Mailing Address
KIYANIE CHAQUEZ FEDRICK
DEPT LA 22763
PASADENA, CA 91185-2763
Phone number: 866-523-4268
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