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1336889047
BALI SOUTHAM
LONG BEACH, CA
NPI
1336889047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-03-30
Last Update Date
2022-03-30
Business Address
BALI SOUTHAM
3431 CHERRY AVE STE B
LONG BEACH, CA 90807-4911
Phone number: 855-223-7123
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Mailing Address
BALI SOUTHAM
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 855-223-7123
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