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1073083523
STEPHANIE NICCOLE IPPOLITO
RIVERBANK, CA
NPI
1073083523
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Former Name
STEPHANIE NICCOLE CASTREJON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-11-27
Last Update Date
2018-11-27
Business Address
Mrs. STEPHANIE NICCOLE IPPOLITO
5501 ANTIQUE ROSE WAY
RIVERBANK, CA 95367-9505
Phone number: 209-863-2450
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Mailing Address
Mrs. STEPHANIE NICCOLE IPPOLITO
3425 COFFEE RD STE C2
MODESTO, CA 95355-1582
Phone number: 209-863-2450
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