Individual
DANIELA TABLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 47TH ST SPC D-22, SAN DIEGO, CA 92102
(619) 530-1435
Mailing address
303 47TH ST SPC D-22, SAN DIEGO, CA 92102
(619) 530-1435
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
07/28/2021
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