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Organization
FOOTPRINTS BEHAVIORAL INTERVENTIONS
Active
Organization
FOOTPRINTS BEHAVIORAL INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIN CONNOR LPN (PROVIDER RELATIONS COORDINATOR)
50329853589
Entity
Organization
Contact information
Practice address
11037 WARNER AVE, SUITE 339, FOUNTAIN VALLEY, CA 92708-4007
(800) 273-4292
(949) 253-4627
Mailing address
11037 WARNER AVE, SUITE 339, FOUNTAIN VALLEY, CA 92708-4007
(800) 273-4292
(949) 253-4627
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/10/2014
Last updated
04/10/2014
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