Organization
BEHAVIORAL SUPPORT PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CRYSTAL MICHELLE GUTIERREZ M.A., BCBA (CASE SUPERVISOR)
(818) 304-1313
Entity
Organization
Contact information
Practice address
12443 LEWIS ST, SUITE 201, GARDEN GROVE, CA 92840-4650
(714) 748-4440
Mailing address
522 WYCLIFFE, IRVINE, CA 92602-1213
(818) 304-1313
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18868
CA
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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