Most Relevant Information
Provider Data
| NPI Number: | 1003476243 |
| Provider Name: | MARK VINCENZO CREVELLI BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 1-19-36925 |
Most Important Dates
| Enumeration Date: | 06/19/2019 |
| Last Updated: | 06/19/2019 |
Provider Practice Location
18726 S WESTERN AVE
GARDENA
CA
902483813
Practice Location Phone/Fax
| Phone: | 3108560800 |
| Fax: |
Provider Mailing Location
18726 S WESTERN AVE
GARDENA
CA
902483813
Provider Mailing Phone/Fax
| Phone: | 3108560800 |
| Fax: |