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General NPI Number Information
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NPI Number | 1790024446
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Entity Type | Individual
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Provider Name | MANUELA DEL MAR GARCIA AMAYA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 449 E PROVIDENCIA AVE APT H
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City | BURBANK
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State | CA
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Zip | 91501-2497
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Country | US
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Telephone | 818-679-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 449 E PROVIDENCIA AVE APT H
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City | BURBANK
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State | CA
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Zip | 91501-2497
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | D8854276
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License Number State | CA
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