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1225817281
MIRA PERIASAMY
FAIRFIELD, CA
NPI
1225817281
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-09-27
Last Update Date
2024-06-28
Business Address
MIRA PERIASAMY
796 DOGWOOD CIR
FAIRFIELD, CA 94533-1457
Phone number: 707-344-5826
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Mailing Address
MIRA PERIASAMY
350 FAIRWAY DR STE 101
DEERFIELD BEACH, FL 33441-1834
Phone number: 877-418-2975
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