Individual
EMMANUEL MARAVILLA-ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3315 S 23RD ST STE 102, TACOMA, WA 98405-1615
(253) 345-5720
Mailing address
5850 GRANITE PKWY STE 600, PLANO, TX 75024-6753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
WDLBT9TD613B
WA
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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