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1528561180
MARISSA LANGE
ELK GROVE, CA
NPI
1528561180
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA 18-47217)
Enumeration Date
2018-03-09
Last Update Date
2019-03-04
Business Address
MARISSA LANGE
9355 E STOCKTON BLVD STE 100
ELK GROVE, CA 95624-9476
Phone number: 916-683-1109
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Mailing Address
MARISSA LANGE
PO BOX 5157
MODESTO, CA 95352-5157
Phone number: 209-572-2589
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