Individual
ELIDA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7401 W GRANDRIDGE BLVD STE 102, KENNEWICK, WA 99336-7831
(425) 977-0088
Mailing address
421 S DOUGLAS AVE, PASCO, WA 99301-4464
(509) 851-7622
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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