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1164086997
KEVIN BLANKENSHIP
TRACY, CA
NPI
1164086997
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-04-26
Last Update Date
2019-04-26
Business Address
KEVIN BLANKENSHIP
510 WHISPERING WIND DR STE 110
TRACY, CA 95377-8119
Phone number: 209-832-7756
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Mailing Address
KEVIN BLANKENSHIP
PO BOX 5157
MODESTO, CA 95352-5157
Phone number: 209-572-2589
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