Individual
MS. ADRIELLE JARVIS-SQUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
600 W BROADWAY STE 300, GLENDALE, CA 91204-1025
(310) 856-0800
(855) 568-2494
Mailing address
18726 S WESTERN AVE, GARDENA, CA 90248-3813
(310) 856-0800
(855) 568-2494
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
01/24/2022
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