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1508341827
JERIQUE DAYNE SUBA
ELK GROVE, CA
NPI
1508341827
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA 18-66061)
Enumeration Date
2018-10-02
Last Update Date
2019-03-04
Business Address
JERIQUE DAYNE SUBA
9355 E STOCKTON BLVD STE 100
ELK GROVE, CA 95624-9476
Phone number: 916-683-1109
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Mailing Address
JERIQUE DAYNE SUBA
PO BOX 5157
MODESTO, CA 95352-5157
Phone number: 209-572-2589
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