Individual
PHYLLESHIA MANGLONA AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4430 CONSER WAY NE APT 201, SALEM, OR 97305-4056
(971) 517-4943
Mailing address
4430 CONSER WAY NE APT 201, SALEM, OR 97305-4056
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/04/2019
Last updated
08/04/2019
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