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General NPI Number Information
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NPI Number | 1821765587
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Entity Type | Individual
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Provider Name | MOLLY GUIREMAND
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 760 SOUTH MAIN ST. SUIT C2
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City | GRASS VALLEY
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State | CA
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Zip | 95945-9594
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Country | US
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Telephone | 530-265-5811
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Fax |
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Provider Business Mailing Address
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Address Line | 3765 GRASS VALLEY HWY SPC 252
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City | AUBURN
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State | CA
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Zip | 95602-2036
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Country | US
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Telephone | 530-265-5811
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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