Individual
JAMIE YVONNE CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2462 BALD EAGLE LN APT D, EIELSON AFB, AK 99702-4007
(925) 305-6722
Mailing address
2462 BALD EAGLE LN APT D, EIELSON AFB, AK 99702-4007
(925) 305-6722
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Enumeration date
03/14/2018
Last updated
01/17/2025
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