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1144036963
DERRICK ANDRE JANUARY
LONG BEACH, CA
NPI
1144036963
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-12-06
Last Update Date
2024-12-06
Business Address
DERRICK ANDRE JANUARY
4300 LONG BEACH BLVD STE 100
LONG BEACH, CA 90807-2008
Phone number: 855-223-7123
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Mailing Address
DERRICK ANDRE JANUARY
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number:
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