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1285348854
STACEY DIAZ BANUELOS
WEST COVINA, CA
NPI
1285348854
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-01-09
Last Update Date
2023-01-09
Business Address
STACEY DIAZ BANUELOS
1000 LAKES DR STE 320
WEST COVINA, CA 91790-2938
Phone number: 888-428-3223
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Mailing Address
STACEY DIAZ BANUELOS
4221 WILSHIRE BLVD STE 300A
LOS ANGELES, CA 90010-3537
Phone number: 888-428-3223
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