Individual
MRS. ANDREA MICHELE MACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B,C,B,A,
Contact information
Practice address
41951 REMINGTON AVE, STE 210, TEMECULA, CA 92590-2552
(951) 813-4034
(951) 813-4035
Mailing address
40485 MURRIETA HOT SPRINGS RD, SUITE B-4, #146, MURRIETA, CA 92563-6406
(619) 804-3401
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1052486
CA
Other
Enumeration date
08/06/2008
Last updated
10/01/2012
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