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1093538084
JAKE LEE DE SOUZA
SANTA ROSA, CA
NPI
1093538084
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-11-06
Last Update Date
2024-11-06
Business Address
JAKE LEE DE SOUZA
1160 N DUTTON AVE STE 140
SANTA ROSA, CA 95401-4652
Phone number: 855-223-7123
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Mailing Address
JAKE LEE DE SOUZA
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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