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1316606551
LICETH BAUTISTA
SANTA CRUZ, CA
NPI
1316606551
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-12-15
Last Update Date
2021-12-15
Business Address
LICETH BAUTISTA
749 37TH AVE
SANTA CRUZ, CA 95062-5124
Phone number: 844-322-7483
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Mailing Address
LICETH BAUTISTA
749 37TH AVE
SANTA CRUZ, CA 95062-5124
Phone number: 844-322-7483
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