Individual
ANGIE MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 7TH AVE STE 150, SANTA CRUZ, CA 95062-4669
(831) 462-1060
Mailing address
200 7TH AVE STE 150, SANTA CRUZ, CA 95062-4669
(831) 462-1060
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578620183
—
CA
Enumeration date
08/04/2016
Last updated
08/04/2016
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