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1417725102
MIKELL WYATT
GARDENA, CA
NPI
1417725102
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-12-13
Last Update Date
2023-12-13
Business Address
MIKELL WYATT
1508 W ARTESIA SQ APT B
GARDENA, CA 90248-4773
Phone number: 800-249-1266
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Mailing Address
MIKELL WYATT
1301 E ORANGEWOOD AVE
ANAHEIM, CA 92805-6807
Phone number: 800-249-1266
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