Individual
ADRIENNE MUBAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
14630 GAULT ST, APT 5, VAN NUYS, CA 91405-3048
(213) 595-5713
Mailing address
14630 GAULT ST, APT 5, VAN NUYS, CA 91405-3048
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-6703
CA
Other
Enumeration date
01/10/2013
Last updated
01/10/2013
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