Most Relevant Information
Provider Data
| NPI Number: | 1003630906 |
| Provider Name: | MICHELLE CARMONA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/08/2024 |
| Last Updated: | 11/08/2024 |
Provider Practice Location
100 N PACIFIC COAST HWY STE 1400
EL SEGUNDO
CA
902455602
Practice Location Phone/Fax
| Phone: | 3108560800 |
| Fax: |
Provider Mailing Location
100 N PACIFIC COAST HWY STE 1400
EL SEGUNDO
CA
902455602
Provider Mailing Phone/Fax
| Phone: | 3108560800 |
| Fax: |