Most Relevant Information
Provider Data
NPI Number: | 1003541798 |
Provider Name: | ALYSSA MANDY ITURRIAGA |
Entity Type: | Individual |
Taxonomy Code: | 106S00000X |
Specialty: | Behavior Technician |
License Number: |
Most Important Dates
Enumeration Date: | 07/18/2022 |
Last Updated: | 08/05/2022 |
Provider Practice Location
1811 GRAND CANAL BLVD STE 2
STOCKTON
CA
952078107
Practice Location Phone/Fax
Phone: | 2094528996 |
Fax: |
Provider Mailing Location
350 FAIRWAY DR STE 101
DEERFIELD BEACH
FL
334411834
Provider Mailing Phone/Fax
Phone: | 8774182978 |
Fax: | 8665002186 |