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1114587680
BENJAMIN R IDARIUS
PETALUMA, CA
NPI
1114587680
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-06-17
Last Update Date
2019-06-17
Business Address
BENJAMIN R IDARIUS
101 H ST. STE. L
PETALUMA, CA 94952
Phone number: 866-206-2008
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Mailing Address
BENJAMIN R IDARIUS
1961 H ST APT D
ARCATA, CA 95521-5633
Phone number:
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