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General NPI Number Information
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NPI Number | 1114431392
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Entity Type | Organization
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Legal Business Name | ART AUTISM RELATED THERAPY
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Dates
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Enumeration Date | 11/26/2017
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 10134 6TH ST STE I
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5857
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Country | US
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Telephone | 909-304-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 10134 6TH ST STE I
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5857
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Country | US
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Telephone | 909-304-1039
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | SANDRA PALOMO
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Credential |
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Telephone | 626-664-8379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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