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Individual

LETICIA ISABEL BANUELOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
242 S 1ST AVE, YUMA, AZ 85364-2264
(928) 919-9521
Mailing address
242 S 1ST AVE, YUMA, AZ 85364-2264
(928) 919-9521

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/25/2021
Last updated
03/25/2021
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