Individual
AMANIQUE BIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
632 W 11TH ST STE 119, TRACY, CA 95376-3860
(209) 237-2484
Mailing address
632 W 11TH ST STE 119, TRACY, CA 95376-3860
(209) 237-2484
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2355S0801X
Speech-Language Assistant
Primary
6181
CA
Other
Enumeration date
07/26/2018
Last updated
11/05/2020
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