Most Relevant Information
Provider Data
| NPI Number: | 1003382144 |
| Provider Name: | DENEAN LYNN OVERTON-RUSSELL |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | A1896003 |
Most Important Dates
| Enumeration Date: | 10/16/2018 |
| Last Updated: | 12/19/2022 |
Provider Practice Location
1333 S MAYFLOWER AVE STE 220
MONROVIA
CA
910165239
Practice Location Phone/Fax
| Phone: | 8888050759 |
| Fax: |
Provider Mailing Location
1063 MCGAW AVE STE 100
IRVINE
CA
926145554
Provider Mailing Phone/Fax
| Phone: | 3234547937 |
| Fax: | 3232920053 |