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Individual
IVAN JOSEPH MUMM
Active
Individual
IVAN JOSEPH MUMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
46-1305562
CA
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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