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Organization
SEACOAST BEHAVIOR, LLC
Active
Organization
SEACOAST BEHAVIOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALERIE GEST (CLINICAL SUPERVISOR)
(619) 836-0829
Entity
Organization
Contact information
Practice address
536 SHOREBIRD WAY, IMPERIAL BEACH, CA 91932
(757) 404-8176
Mailing address
536 SHOREBIRD WAY, IMPERIAL BEACH, CA 91932-2155
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26403
AL
Other
Enumeration date
05/30/2018
Last updated
06/05/2018
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