Most Relevant Information
Provider Data
| NPI Number: | 1003551219 |
| Provider Name: | ENCHANTE DRAKE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/02/2022 |
| Last Updated: | 05/02/2022 |
Provider Practice Location
1333 S MAYFLOWER AVE STE 220
MONROVIA
CA
910165239
Practice Location Phone/Fax
| Phone: | 8182416780 |
| Fax: |
Provider Mailing Location
1333 S MAYFLOWER AVE STE 220
MONROVIA
CA
910165239
Provider Mailing Phone/Fax
| Phone: | 2163348684 |
| Fax: |