Individual
SUMMER TARA MIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9920 PACIFIC HEIGHTS BLVD STE 150, SAN DIEGO, CA 92121-4361
(303) 989-8172
Mailing address
390 UNION BLVD STE 300, LAKEWOOD, CO 80228-6514
(303) 989-8172
(303) 984-4366
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
CA
106E00000X
Assistant Behavior Analyst
Primary
—
CA
106S00000X
Behavior Technician
—
CA
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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