Individual
MELODY RENAE DE LA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9939 RAMONA AVE, MONTCLAIR, CA 91763-3036
(909) 712-8604
Mailing address
9939 RAMONA AVE, MONTCLAIR, CA 91763-3036
(909) 712-8604
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
CA
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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