Individual
KELLEE NICOLE FUGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 NE 136TH AVE STE 220, VANCOUVER, WA 98684-6951
(360) 952-7051
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(183) 452-3458
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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