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Individual

ALEXANDER SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7373 UNIVERSITY AVE STE 202, LA MESA, CA 91942-0524
(619) 713-0737
(619) 639-8277
Mailing address
7373 UNIVERSITY AVE STE 202, LA MESA, CA 91942-0524
(619) 713-0737
(619) 639-8277

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-136032
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-20-136032
RBT
CA
Enumeration date
09/23/2020
Last updated
09/23/2020
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