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1265902886
EDGAR IVAN IZEHUATL
SACRAMENTO, CA
NPI
1265902886
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-11-26
Last Update Date
2018-11-26
Business Address
EDGAR IVAN IZEHUATL
1300 ETHAN WAY SUITE 175
SACRAMENTO, CA 95825
Phone number: 209-521-4791
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Mailing Address
EDGAR IVAN IZEHUATL
3425 COFFE RD SUITE C2
MODESTO, CA 95355
Phone number: 209-521-4791
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