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1922844190
EVIN MARK LONG
RANCHO CORDOVA, CA
NPI
1922844190
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA W1761463)
Enumeration Date
2024-07-06
Last Update Date
2024-07-06
Business Address
EVIN MARK LONG
2865 SUNRISE BLVD
RANCHO CORDOVA, CA 95742-6538
Phone number: 805-372-2897
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Mailing Address
EVIN MARK LONG
2865 SUNRISE BLVD
RANCHO CORDOVA, CA 95742-6538
Phone number:
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