Individual
CAMILLE THEODORA FORTUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11650 IBERIA PL, SAN DIEGO, CA 92128-2406
(858) 264-5858
Mailing address
11650 IBERIA PL, SAN DIEGO, CA 92128-2406
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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