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1710704945
JORGE BRIAN LOPEZ MANRIQUEZ
FAIRFIELD, CA
NPI
1710704945
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-09-19
Last Update Date
2024-09-19
Business Address
JORGE BRIAN LOPEZ MANRIQUEZ
2450 MARTIN RD STE 100
FAIRFIELD, CA 94534-1018
Phone number: 855-223-7123
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Mailing Address
JORGE BRIAN LOPEZ MANRIQUEZ
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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