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Individual

ADAURE CELENE AMUGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17037 CHATSWORTH ST, GRANADA HILLS, CA 91344-5825
(818) 655-0040
Mailing address
17037 CHATSWORTH ST, GRANADA HILLS, CA 91344-5825
(818) 655-0040

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A6715099
DRIVER LICENSE
CA
Enumeration date
09/02/2021
Last updated
06/03/2022
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