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Organization
MARICEL DOMIQUEL
Active
Organization
MARICEL DOMIQUEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARICEL TABARES DOMIQUEL MA (PROGRAM SUPERVISOR)
(626) 513-3847
Entity
Organization
Contact information
Practice address
10808 FOOTHILL BLVD # 198, RANCHO CUCAMONGA, CA 91730-3889
(626) 513-3847
Mailing address
10808 FOOTHILL BLVD # 198, RANCHO CUCAMONGA, CA 91730-3889
(626) 513-3847
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/05/2015
Last updated
12/05/2015
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