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1992264170
MICHAEL ETHERIDGE
SAN BRUNO, CA
NPI
1992264170
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-03-18
Last Update Date
2019-03-18
Business Address
MICHAEL ETHERIDGE
751 CAMINO PLZ STE A
SAN BRUNO, CA 94066-3401
Phone number: 652-627-8045
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Mailing Address
MICHAEL ETHERIDGE
390 UNION BLVD STE 300
LAKEWOOD, CO 80228-6514
Phone number: 303-989-8172
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