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1194318360
SARA EZZAT ANNICK TAVAKOLI
BALTIMORE, MD
NPI
1194318360
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-02-18
Last Update Date
2021-08-20
Business Address
SARA EZZAT ANNICK TAVAKOLI
400 E PRATT ST
BALTIMORE, MD 21202-3116
Phone number: 866-586-4861
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Mailing Address
SARA EZZAT ANNICK TAVAKOLI
850 TOWBIN AVE
LAKEWOOD, NJ 08701-5928
Phone number: 732-515-3709
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