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1588152144
MICHAEL COSTILLA
FRESNO, CA
NPI
1588152144
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-04-28
Last Update Date
2018-04-28
Business Address
MICHAEL COSTILLA
6770 N WEST AVE
FRESNO, CA 93711-1399
Phone number: 818-241-6780
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Mailing Address
MICHAEL COSTILLA
206 N JACKSON ST STE 202
GLENDALE, CA 91206-4330
Phone number: 818-241-6678
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