Individual
CONSUELO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9620 CHESAPEAKE DR STE 105, SAN DIEGO, CA 92123-1324
(626) 622-1265
Mailing address
9620 CHESAPEAKE DR STE 105, SAN DIEGO, CA 92123-1324
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CA
Other
Enumeration date
08/26/2019
Last updated
05/14/2025
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