Most Relevant Information
Provider Data
| NPI Number: | 1003386491 |
| Provider Name: | MIA MONROE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/28/2018 |
| Last Updated: | 11/28/2018 |
Provider Practice Location
4950 SAN BERNARDINO ST STE 101
MONTCLAIR
CA
917632328
Practice Location Phone/Fax
| Phone: | 8007491965 |
| Fax: |
Provider Mailing Location
4950 SAN BERNARDINO ST STE 101
MONTCLAIR
CA
917632328
Provider Mailing Phone/Fax
| Phone: | 8007491965 |
| Fax: |