Individual
ANGEL N JUANSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 CANAL ST FL 4, BOSTON, MA 02114-2018
(888) 922-2843
Mailing address
18726 S WESTERN AVE, GARDENA, CA 90248-3813
(310) 856-0800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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