Individual
CHAMUDI PABASARA HALLAWAARACHCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12437 LEWIS ST STE 100, GARDEN GROVE, CA 92840
(714) 202-0118
Mailing address
12437 LEWIS ST STE 100, GARDEN GROVE, CA 92840-4651
(714) 202-0118
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/27/2023
Last updated
10/04/2024
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