Individual
ELLIOT THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9890 COUNTY FARM RD STE 3, RIVERSIDE, CA 92503-3678
(951) 509-8320
Mailing address
777 OCHEE CIR, CORONA, CA 92879-8571
(951) 833-1532
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
09/16/2024
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