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Organization
SQUARE ONE
Active
Organization
SQUARE ONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURIE MCKINNIE (OWNER)
(916) 690-6985
Entity
Organization
Contact information
Practice address
3195 ZINFANDEL DR, BLDG G STE 21, RANCHO CORDOVA, CA 95670-6376
(916) 690-6985
(916) 731-5576
Mailing address
3195 ZINFANDEL DR, BLDG G STE 21, RANCHO CORDOVA, CA 95670-6376
(916) 690-6985
(916) 731-5576
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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