Most Relevant Information
Provider Data
| NPI Number: | 1003411422 |
| Provider Name: | AMY BALFANZ-GUTIERREZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-20-145478 |
Most Important Dates
| Enumeration Date: | 12/02/2020 |
| Last Updated: | 12/02/2020 |
Provider Practice Location
9245 ACTIVITY RD STE 106
SAN DIEGO
CA
921264442
Practice Location Phone/Fax
| Phone: | 8584280222 |
| Fax: | 8473483706 |
Provider Mailing Location
5 REVERE DR STE 120
NORTHBROOK
IL
600628005
Provider Mailing Phone/Fax
| Phone: | 8584280222 |
| Fax: | 8473483706 |