Individual
CHRISTIAN IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3152 RED HILL AVE STE 100, COSTA MESA, CA 92626-3418
(714) 881-0427
Mailing address
5944 BIG PINE DR, FONTANA, CA 92336-4556
(909) 684-3833
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CA
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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