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1871095067
SHANICE ESCHELLE TAVITA
PETALUMA, CA
NPI
1871095067
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-03-02
Last Update Date
2018-03-02
Business Address
SHANICE ESCHELLE TAVITA
101 H ST STE L
PETALUMA, CA 94952-5100
Phone number: 866-206-2008
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Mailing Address
SHANICE ESCHELLE TAVITA
2253 E LELAND RD APT 74
PITTSBURG, CA 94565-5140
Phone number: 925-597-7433
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