Individual
ASHLEY LAUREN DE LA MATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1063 MCGAW AVE, IRVINE, CA 92614-5505
(714) 332-7144
Mailing address
1063 MCGAW AVE, IRVINE, CA 92614-5505
(714) 332-7144
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33130
CA
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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