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1861221731
ANDREA HUAYTALLA DIAZ
BENTON HARBOR, MI
NPI
1861221731
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-07-30
Last Update Date
2024-07-30
Business Address
ANDREA HUAYTALLA DIAZ
1651 E NICKERSON AVE
BENTON HARBOR, MI 49022-2469
Phone number: 269-876-5697
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Mailing Address
ANDREA HUAYTALLA DIAZ
1651 E NICKERSON AVE
BENTON HARBOR, MI 49022-2469
Phone number: 269-876-5697
Copy
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