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1164180634
LEVI DERTING
CORONA, CA
NPI
1164180634
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-12-02
Last Update Date
2021-12-02
Business Address
LEVI DERTING
1295 CORONA POINTE CT STE 102
CORONA, CA 92879-1721
Phone number: 855-223-7123
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Mailing Address
LEVI DERTING
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 855-223-7123
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