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1215547906
MARYDANG PHANIXAY
EMERYVILLE, CA
NPI
1215547906
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-08-06
Last Update Date
2020-08-06
Business Address
MARYDANG PHANIXAY
2354 POWELL ST STE A-1
EMERYVILLE, CA 94608-1738
Phone number: 877-242-2884
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Mailing Address
MARYDANG PHANIXAY
2354 POWELL ST STE A-1
EMERYVILLE, CA 94608-1738
Phone number: 877-242-2884
Copy
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