Individual
MS. CHANTI FRITZSCHING WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
126 SOUTH H STREET, LOMPOC, CA 93436
(805) 610-8064
Mailing address
591 ASH STREET, LOS OSOS, CA 93402
(805) 610-8064
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-02-0808
CA
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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