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1952125452
OMAR DALE DESOUZA
PORT ST LUCIE, FL
NPI
1952125452
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-11-12
Last Update Date
2024-11-12
Business Address
OMAR DALE DESOUZA
247 SW PORT ST LUCIE BLVD
PORT ST LUCIE, FL 34984-5015
Phone number: 772-207-1356
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Mailing Address
OMAR DALE DESOUZA
7500 SAN FELIPE ST STE 990
HOUSTON, TX 77063-1708
Phone number:
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