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Individual

KARLA SAMANTHA WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7090 MIRATECH DR, SAN DIEGO, CA 92121-3109
(619) 571-8451
Mailing address
2428 EASTRIDGE LOOP, CHULA VISTA, CA 91915-1114
(619) 571-8451

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
CA

Other

Enumeration date
11/02/2020
Last updated
11/02/2020
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