Most Relevant Information
Provider Data
| NPI Number: | 1003310764 |
| Provider Name: | BETHEL GEBREYESUS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-18-50539 |
Most Important Dates
| Enumeration Date: | 03/19/2018 |
| Last Updated: | 03/19/2018 |
Provider Practice Location
120 THERESA AVE
AMERICAN CANYON
CA
945039654
Practice Location Phone/Fax
| Phone: | 7075610134 |
| Fax: |
Provider Mailing Location
120 THERESA AVE
AMERICAN CANYON
CA
945039654
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |