Individual
AMANDA R MESSINA-GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA 1-18-29787
Contact information
Practice address
124 PAVON, HERCULES, CA 94547-3752
(805) 304-9968
Mailing address
124 PAVON, HERCULES, CA 94547-3752
(805) 304-9968
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29787
CA
Other
Enumeration date
03/28/2018
Last updated
04/07/2020
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