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1124684451
KEANNA G THEOBALT
TEMECULA, CA
NPI
1124684451
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: MO RBT-18-70458)
Enumeration Date
2019-05-13
Last Update Date
2019-06-11
Business Address
KEANNA G THEOBALT
43537 RIDGE PARK DR
TEMECULA, CA 92590-3615
Phone number: 858-689-2027
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Mailing Address
KEANNA G THEOBALT
9466 BLACK MOUNTAIN RD STE 100
SAN DIEGO, CA 92126-4550
Phone number: 858-689-2027
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