Individual
MS. MADISON DE LA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5595 EQUITY AVE, ST 400, RENO, NV 89502-2589
(775) 322-6060
Mailing address
1443 W 800 N STE 103, OREM, UT 84057-2878
(801) 655-4950
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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