Individual
ACACIA MARIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3978 SORRENTO VALLEY BLVD STE 100, SAN DIEGO, CA 92121-1436
(858) 353-7723
Mailing address
1720 MELROSE AVE UNIT 44, CHULA VISTA, CA 91911-6586
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-63941
CA
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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