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1871060038
AMANDA NICOLE DALLAS
STOCKTON, CA
NPI
1871060038
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA RBT-17-34011)
Enumeration Date
2018-10-25
Last Update Date
2024-09-05
Business Address
AMANDA NICOLE DALLAS
2453 GRAND CANAL BLVD STE A
STOCKTON, CA 95207-8138
Phone number: 855-223-7123
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Mailing Address
AMANDA NICOLE DALLAS
PO BOX 33568
SAN DIEGO, CA 92163-3568
Phone number: 855-223-7123
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